Organization
HUDSON PREMIER PHYSICAL THERAPY AND FITNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY JO HUDSON DPT (OWNER)
(304) 845-9550
Entity
Organization
Contact information
Practice address
132 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-1029
(304) 845-9550
(304) 845-9540
Mailing address
132 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-1029
(304) 845-9550
(304) 845-9540
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
002670
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001994940
BCBS
WV
01
—
1215117833
INDIVIDUAL NPI
WV
05
—
3810010547
—
WV
Enumeration date
12/23/2015
Last updated
01/15/2016
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