Organization
PROFESSIONAL SPORTSCARE & REHAB OF WEST VIRGINIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
207 S PRINCESS ST STE 3AND4, SHEPHERDSTOWN, WV 25443-1581
(304) 876-8600
(304) 876-8601
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3133
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 002689
WV
Other
Enumeration date
04/21/2009
Last updated
11/01/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up