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Organization
PEDIATRIC THERAPY SERVICES,LLC
Active
Organization
PEDIATRIC THERAPY SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABITHA JEFFRIES (DIRECTOR)
(304) 698-6081
Entity
Organization
Contact information
Practice address
309 ELEANOR DR, MORGANTOWN, WV 26508-9004
(304) 698-6081
(304) 381-2035
Mailing address
309 ELEANOR DR, MORGANTOWN, WV 26508-9004
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
27534
WV
171W00000X
Contractor
Primary
22423229
WV
252Y00000X
Early Intervention Provider Agency
22423229
WV
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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