Individual
COLLEENA LYNN LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 HOSPITAL DR STE 3, PETERSBURG, WV 26847-9570
(304) 257-1015
(304) 257-1129
Mailing address
880 GRIZZLY RD, MAYSVILLE, WV 26833-8736
(304) 813-3991
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002778
WV
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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