Organization
MOUNTAIN RIVER PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BURTON R REED PT, OCS, FAAOMPT (OWNER/PT)
(304) 865-6778
Entity
Organization
Contact information
Practice address
1212 GARFIELD AVE, SUITE 200, PARKERSBURG, WV 26101-3247
(304) 865-6778
(304) 865-7400
Mailing address
415 36TH ST, SUITE 100, PARKERSBURG, WV 26101-1005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2701768
—
OH
05
—
3810003616
—
WV
01
—
DA4403
MEDICARE ID TYPE UNSPEC
—
Enumeration date
07/29/2006
Last updated
05/27/2016
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