Individual
MARY FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 GREY STONE DRIVE, BEAVER, WV 25813
(304) 252-6317
Mailing address
100 GREY STONE DRIVE, BEAVER, WV 25813
(304) 252-6317
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001628
WV
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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