Organization
PERFORMANCE PHYSICAL THERAPY AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA G BEAVER MPT (OWNER)
(304) 763-5121
Entity
Organization
Contact information
Practice address
1338 RITTER DR., DANIELS, WV 25832
(304) 890-3480
Mailing address
204 GREENBRIER RD, DANIELS, WV 25832-9703
(304) 763-5121
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1641
WV
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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