Organization
PROFESSIONAL MEDICAL REHABILITATION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J DAVID LYNCH JR. M.D. (CEO)
(304) 983-7766
Entity
Organization
Contact information
Practice address
460 MYLAN PARK LN, MORGANTOWN, WV 26501-2281
(304) 983-7766
(304) 983-7768
Mailing address
460 MYLAN PARK LN, MORGANTOWN, WV 26501-2281
(304) 983-7766
(304) 983-7768
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
WV16960
WV
225100000X
Physical Therapist
PT002617
WV
225200000X
Physical Therapy Assistant
PTA001299
WV
225700000X
Massage Therapist
1999 0357
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000578387
HIGHMARK BLUESHIELD
WV
01
—
001371360
MT STATE BCBS
WV
01
—
223202
CARELINK
WV
05
—
3810007971
—
WV
Enumeration date
08/28/2007
Last updated
01/27/2016
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