OrganizationActive
Pediatric Physical Therapy, LLC
NPI 1750657664 · Physical Therapy Clinic/Center · Fairmont, WV
Provider details
- NPI number
- 1750657664
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Nancy Hickman, President(304) 366-8395
- License
- 1046-0165 (WV)
Specialties & taxonomies
Ambulatory Health Care Facilities
Agencies
Practice location
Rr 6 Box 260-6e
Fairmont, WV 26554-9396
Phone: (304) 367-0750
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 88
Colfax, WV 26566-0088
Registry dates
- Enumerated
- 2012-03-25
- Last updated
- 2012-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.