Organization
SOUTHERN WEST VIRGINIA PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK M ELLIS MSPT (PHYSICAL THERAPIST/ OWNER)
(304) 855-9500
Entity
Organization
Contact information
Practice address
6107 CRAWLEY CREEK RD., CHAPMANVILLE, WV 25508
(304) 855-9500
(304) 855-9525
Mailing address
PO BOX 1647, CHAPMANVILLE, WV 25508-1647
(304) 855-9500
(304) 855-9525
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002118
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302394000
—
WV
Enumeration date
11/26/2007
Last updated
07/24/2008
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