Organization
MEDCARE THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A BRISCOE MPT (OWNER, PHYSICAL THERAPIST)
(304) 776-5031
Entity
Organization
Contact information
Practice address
314 GOFF MTN RD, SUITE 13, CROSS LANES, WV 25313
(304) 776-5031
(304) 204-6332
Mailing address
314 GOFF MTN. RD, SUITE 13, CROSS LANES, WV 25313
(304) 776-5031
(304) 204-6332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002137
WV
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705831
MOUNTIAN STATE BC/BS
WV
05
—
0206908000
—
WV
05
—
730106300
—
WV
Enumeration date
09/12/2006
Last updated
09/01/2011
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