Individual
MS. TRICIA L. DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
313 MACCORKLE AVE SW, CHARLESTON, WV 25303-1263
(304) 744-2300
(304) 744-5891
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5890
(740) 446-5532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001259
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217253
ANTHEM BCBS
—
05
—
0157212000
—
WV
01
—
1942229711
NPI
—
01
—
2229510
MOLINA MEDICAID
OH
Enumeration date
07/19/2006
Last updated
07/30/2007
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