Organization
MOUNTAIN RIVER PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BURTON RICHARD REED P.T. (OWNER-THERAPIST)
(304) 865-6778
Entity
Organization
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 1, VIENNA, WV 26105-4131
(304) 865-6777
(304) 865-6780
Mailing address
415 36TH ST, SUITE 100, PARKERSBURG, WV 26101-1005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2750858
—
OH
05
—
3810009018
—
WV
01
—
DA4403
MEDICARE ID TYPE UNSPEC
—
Enumeration date
05/09/2007
Last updated
05/27/2016
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