Organization
PROFESSIONAL SPORTSCARE & REHAB OF WEST VIRGINIA, LLC
Active
Other names
Pivot Physical Therapy of West Virginia
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
80 RETAIL COMMONS PKWY STE 3, MARTINSBURG, WV 25403-6182
(919) 373-2919
(410) 648-4868
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
(410) 648-4868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/04/2025
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