Professional Sportscare & Rehab of West Virginia, LLC

NPI #1407301518 in Charles Town, West Virginia

Provider Information

NPI Number
1407301518
Entity Type
Organization
Organization Name
Professional Sportscare & Rehab of West Virginia, LLC
Primary Specialty
Physical Therapist
Enumeration Date
Aug 18, 2016
Last Updated
Nov 1, 2024

Practice Location

Address
46 TRIFECTA PL
Address 2
STE 104
ZIP Code
25414-5652
Phone
(304) 728-9087

Authorized Official

Name
TASHEDA BROUGHTON, PESC
Title
MANAGER, CREDENTIALING
Phone
(252) 248-3313

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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