Organization
MOUNTAIN RIDGE PHYSICAL THERAPY LLC
Active
Organization
MOUNTAIN RIDGE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK D CLARK DPT, PT, MS, CSCS (OWNER, PHYSICAL THERAPIST)
(304) 685-6064
Entity
Organization
Contact information
Practice address
6000 COOMBS FARM DRIVE, SUITE 202B, MORGANTOWN, WV 26508
(304) 685-6064
Mailing address
6000 COOMBS FARM DRIVE, SUITE 202B, MORGANTOWN, WV 26508
(304) 685-6064
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2714
WV
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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