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Individual

VIRGINIA MOZINGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1114 RIDGE AVE, NEW CUMBERLAND, WV 26047-9537
(304) 564-1098
(304) 564-5020
Mailing address
414 PENCO ROAD, WEIRTON, WV 26062
(304) 723-3780
(304) 723-4110

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001539
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014417000
WV
01
55071930000
WV WORKERS COMP BRICKSTRE
WV
01
55071930003
THE HEALTH PLAN BWC
WV
Enumeration date
10/26/2006
Last updated
03/27/2008
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