Provider Demographics
NPI:1215099023
Name:KIGER, JUSTIN T (MPT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:T
Last Name:KIGER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 36TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-1005
Mailing Address - Country:US
Mailing Address - Phone:304-917-3660
Mailing Address - Fax:304-917-3674
Practice Address - Street 1:68120 TINMAR DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-7799
Practice Address - Country:US
Practice Address - Phone:740-296-5042
Practice Address - Fax:740-296-5320
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2151225100000X
OHPT009099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3041890Medicaid
P00957581OtherRAILROAD MEDICARE
WV3810019525Medicaid
OHH392250Medicare PIN
P00957581OtherRAILROAD MEDICARE
WV4287581Medicare PIN