Individual
RONALD PERRY STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
178 YUMA LANE, AMIGO, WV 25811
(304) 774-0196
Mailing address
P.O. BOX 97, AMIGO, WV 25811
(304) 774-0196
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 001360
WV
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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