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Organization
DYNAMIC HEALTH & ORTHOTICS
Active
Organization
DYNAMIC HEALTH & ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DEREK HOLLINGSWORTH D.O. (OWNER)
(304) 760-8803
Entity
Organization
Contact information
Practice address
3859 TEAYS VALLEY RD, HURRICANE, WV 25526-9622
(304) 760-8803
(304) 760-8825
Mailing address
3859 TEAYS VALLEY RD, HURRICANE, WV 25526-9622
(304) 760-8803
(304) 760-8825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PLLC-124
STATE OF WEST VIRGINIA-BOARD OF OSTEOPATHY
WV
Enumeration date
03/16/2012
Last updated
03/16/2012
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