Organization
MOUNTAIN STATE PHYSICAL THERAPY LLC
Active
Other names
Dino Rovito Etal Ptr, Mountain State Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J. BARRISH PT (PRESIDENT)
(304) 363-8543
Entity
Organization
Contact information
Practice address
200 FAIRMONT AVE STE 104, FAIRMONT, WV 26554-0171
(304) 363-8543
(304) 363-0173
Mailing address
200 FAIRMONT AVE STE 104, FAIRMONT, WV 26554-0171
(304) 363-8543
(304) 363-0173
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202606000
—
WV
01
—
DB3679
RAILROAD MEDICARE
—
Enumeration date
05/19/2006
Last updated
08/08/2023
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