Organization
FOUNTAIN PLACE REHAB INC
Active
Organization
FOUNTAIN PLACE REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABEL C BORROMEO DC (OWNER)
(304) 752-4045
Entity
Organization
Contact information
Practice address
118 NICK SAVAS DR, LOGAN, WV 25601-3468
(304) 752-4045
(304) 752-4045
Mailing address
118 NICK SAVAS DR, LOGAN, WV 25601-3468
(304) 752-4045
(304) 752-4045
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/08/2006
Last updated
08/22/2020
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