Organization
PHYSICAL & MASSAGE THERAPY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA STEPHENSON MASSAGE THERAPIST (LMT)
(304) 431-3535
Entity
Organization
Contact information
Practice address
463D OLD BLUEFIELD RD, PRINCETON, WV 24739-8927
(304) 431-3535
Mailing address
463D OLD BLUEFIELD RD, PRINCETON, WV 24739-8927
(304) 431-3535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002466
WV
225700000X
Massage Therapist
20102705
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002466
PHYSICAL THERAPIST STATE LICENSE
WV
01
—
20102705
STATE LICENSE NUMBER
WV
Enumeration date
03/06/2012
Last updated
03/06/2012
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