Brookeview Physical Therapy | |
47454 Route 52, Kermit, WV 25674-8052 | |
(304) 393-4072 | |
(304) 393-4074 |
Full Name | Brookeview Physical Therapy |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 47454 Route 52, Kermit, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740467463 | NPI | - | NPPES |
002013370 | Other | WV | MOUNTAIN STATE BCBS |
3810011333 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Nicholas Martin |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1124030168 PECOS PAC ID: 0547174310 Enrollment ID: I20031117000432 |
Provider Name | Virginia G Mozingo |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1366527715 PECOS PAC ID: 4981518727 Enrollment ID: I20031117000481 |
Provider Name | Mark W. Mascio |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1568473585 PECOS PAC ID: 6002720877 Enrollment ID: I20031117000550 |
Provider Name | James Christopher Frum |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1942370812 PECOS PAC ID: 4587671235 Enrollment ID: I20060321000460 |
Provider Name | Melissa D Ledson |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1316084528 PECOS PAC ID: 8022193929 Enrollment ID: I20080317000107 |
Provider Name | Cody David Wells |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1629568217 PECOS PAC ID: 7012262405 Enrollment ID: I20180627000035 |
Provider Name | Matthew T Starkman |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1710642731 PECOS PAC ID: 8224427711 Enrollment ID: I20211123001643 |
Mailing Address | Practice Location Address |
---|---|
Brookeview Physical Therapy 414 Penco Rd, Weirton, WV 26062-3822 Ph: (304) 723-3780 | Brookeview Physical Therapy 47454 Route 52, Kermit, WV 25674-8052 Ph: (304) 393-4072 |
Dr. Larissa Stacy, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 47454 Route 52, Kermit, WV 25674 Phone: 304-393-4072 Fax: 304-393-4074 | |
Mrs. Crystal Gail Krimm, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 47454 Route 52, Kermit, WV 25674 Phone: 304-393-4072 |