Organization
CORNERSTONE PEDIATRIC THERAPY CENTER, LLC
Active
Other names
Cornerstone Pediatric Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW R CITERONE (MEMBER)
(304) 672-0077
Entity
Organization
Contact information
Practice address
231 DAVIS ST, BRIDGEPORT, WV 26330-1703
(304) 672-0077
Mailing address
PO BOX 1276, BRIDGEPORT, WV 26330-6276
(304) 672-0077
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
1175
WV
225XP0200X
Pediatric Occupational Therapist
Primary
1175
WV
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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