Individual
MR. JAMES ALLEN MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-8479
Mailing address
RR 1 BOX 256 C, FAIRMONT, WV 26554-9737
(304) 612-0735
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1014
WV
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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