# PUNNAMMA MEMORIAL REHAB CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMR Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861549941
- **Authorized official:** MISS SANDYA RANI KALAPALA (OFFICE MANAGER)
- **Authorized official phone:** (304) 485-7500

## Contact information

- **Practice address:** 1504 GRAND CENTRAL AVE, VIENNA, WV 26105-1058
- **Practice address phone:** (304) 485-7500
- **Practice address fax:** (304) 485-6777
- **Mailing address:** 2323 MURDOCH AVE, PARKERSBURG, WV 26101-2532
- **Mailing address phone:** (304) 485-7500
- **Mailing address fax:** (304) 485-6777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 20619 | WV | — |
| 207R00000X | Internal Medicine Physician | 21321 | WV | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 17059 | WV | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 02/21/2019