Individual
CHARLES PETHTEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001659
WV
Other
Enumeration date
06/13/2026
Last updated
06/13/2026
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