Individual
MRS. ANGELA D BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3589
(304) 766-3793
Mailing address
5409 TIFFANY DR, CROSS LANES, WV 25313-1033
(304) 776-2706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1572
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129415
MAMSI OPTIMUM CHOICE
WV
Enumeration date
05/25/2007
Last updated
07/08/2007
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