Organization
KVPTC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERDINAND P. SORONGON PHYSICAL THERAPIST (ADMINISTRATOR)
(304) 768-3307
Entity
Organization
Contact information
Practice address
1313 DUNBAR AVE, DUNBAR, WV 25064
(304) 768-3307
(304) 768-3620
Mailing address
1313 DUNBAR AVE, DUNBAR, WV 25064
(304) 768-3307
(304) 768-3620
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1112
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156761000
—
WV
05
—
0206427-000
—
WV
Enumeration date
09/20/2006
Last updated
08/22/2020
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