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General NPI Number Information
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NPI Number | 1932758885
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Entity Type | Individual
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Provider Name | HANNAH NICOLE GROWE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 19771 COAL HERITAGE RD
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City | WELCH
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State | WV
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Zip | 24801-9825
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Country | US
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Telephone | 681-201-2009
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Fax |
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Provider Business Mailing Address
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Address Line | 163 VOTIVE PLACE GLADE SPRINGS RESORT
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City | DANIELS
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State | WV
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Zip | 25832
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Country | US
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Telephone | 304-673-9733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT004192
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License Number State | WV
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