Provider Demographics
NPI:1528169976
Name:CHARLESTON PHYSICAL THERAPY SPECIALISTS INC
Entity type:Organization
Organization Name:CHARLESTON PHYSICAL THERAPY SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:304-746-9200
Mailing Address - Street 1:301 R H L BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-8291
Mailing Address - Country:US
Mailing Address - Phone:304-746-9200
Mailing Address - Fax:304-746-9202
Practice Address - Street 1:301 R H L BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-8291
Practice Address - Country:US
Practice Address - Phone:304-746-9200
Practice Address - Fax:304-746-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV040629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001706112OtherMOUNTAIN STATE BCBS
WV001706112OtherMOUNTAIN STATE BCBS