Organization
RIVERSIDE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA BRADFORD GANDEE MPT (OWNER/MANAGER/THERAPIST)
(304) 615-7576
Entity
Organization
Contact information
Practice address
105 SEASONS LN, MINERAL WELLS, WV 26150-8110
(304) 615-7576
(304) 422-4094
Mailing address
105 SEASONS LN, MINERAL WELLS, WV 26150-8110
(304) 615-7576
(304) 422-4094
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2160
WV
Other
Enumeration date
01/24/2012
Last updated
02/09/2012
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