NPI 1194180489

Fairhaven Opco, LLC

Organisation Physical Therapist Huntington, WV

Practice location

Address: 700 Madison Ave, Huntington, WV 25704-2630
Phone: (304) 552-0032
Fax: (304) 522-1481
Mailing address: 121 S Water Ave, Gallatin, TN 37066-2902

Authorised official

Name: Isaac S Dole
Title: Manager
Phone: (312) 724-8950

Registered specialties (2)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

Other Physical Therapist providers in West Virginia →

Occupational Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X

Other Occupational Therapist providers in West Virginia →

Registry record

NPI: 1194180489
Entity type: Organization
NPI issued: 31 Dec 2015
Record last updated: 31 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.