1982993325 NPI number — THE BIOMECHANICS INSTITUTE

Table of content: (NPI 1982993325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982993325 NPI number — THE BIOMECHANICS INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE BIOMECHANICS INSTITUTE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982993325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
517 MARIETTA LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45750-1917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-336-7022
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
417 GRAND PARK DR
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
PARKERSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26105-4049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-834-3905
Provider Business Practice Location Address Fax Number:
304-917-3905
Provider Enumeration Date:
04/06/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOLLINGSWORTH
Authorized Official First Name:
DEREK
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
304-834-3905

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  2360 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)