Organization
PUNNAMMA MEMORIAL REHAB CLINIC
Active
Other names
PMR Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SANDYA RANI KALAPALA (OFFICE MANAGER)
(304) 485-7500
Entity
Organization
Contact information
Practice address
1504 GRAND CENTRAL AVE, VIENNA, WV 26105-1058
(304) 485-7500
(304) 485-6777
Mailing address
2323 MURDOCH AVE, PARKERSBURG, WV 26101-2532
(304) 485-7500
(304) 485-6777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20619
WV
207R00000X
Internal Medicine Physician
21321
WV
208100000X
Physical Medicine & Rehabilitation Physician
Primary
17059
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078260000
—
WV
05
—
0203567000
—
WV
Enumeration date
01/04/2007
Last updated
02/21/2019
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