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Organization

BLUE MOUNTAIN THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH CLINT WADDELL (ADMINISTRATION)
(276) 525-6043
Entity
Organization

Contact information

Practice address
17507 LEE HWY, ABINGDON, VA 24210-7835
(276) 525-6043
(888) 233-7885
Mailing address
17507 LEE HWY, ABINGDON, VA 24210-7835
(276) 525-6043
(888) 233-7885

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
251C00000X
Developmentally Disabled Services Day Training Agency
252Y00000X
Early Intervention Provider Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760818595
VA
Enumeration date
09/25/2013
Last updated
06/16/2022
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