Individual
MARK W. MASCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
414 PENCO RD, WEIRTON, WV 26062
(304) 723-3780
(304) 723-4110
Mailing address
414 PENCO RD, WEIRTON, WV 26062
(304) 723-3780
(304) 723-4110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001071
WV
225100000X
Physical Therapist
PT006827L
PA
225100000X
Physical Therapist
PT007090
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000745332
BLUE CROSS/BLUE SHIELD
WV
05
—
0156598000
—
WV
01
—
151547300
US DEPT OF LABOR
WV
01
—
55071930000
WV WORKERS COMP BRICKSTRE
WV
01
—
55071930003
THE HEALTH PLAN BWC
WV
Enumeration date
08/11/2006
Last updated
04/01/2024
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