Organization
PUNNAMMA MEMORIAL REHAB CLINIC
Active
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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