Individual
MR. JOHN CHRISTOPHER KAZALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT,
Contact information
Practice address
54 W 3RD AVE, WILLIAMSON, WV 25661-3508
(304) 235-4300
(304) 235-0176
Mailing address
PO BOX 844, WILLIAMSON, WV 25661-0844
(412) 779-1164
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002017
WV
225100000X
Physical Therapist
PT013202L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000543
—
WV
01
—
571136141002
BC/BS
WV
Enumeration date
08/11/2006
Last updated
07/08/2007
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