Nathan Brent Justice
Individual provider Active NPI Physical Therapy Assistant · Justice, WV
NPI 1376220384 · NPPES record last updated Jun 30, 2023
Key facts
- NPI
- 1376220384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 67 Grace Street
Justice, WV 24851 - Phone
- (304) 928-3113
- NPI assigned
- Jun 30, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000982 | WV | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 000982 | WV | |
| Physical Therapy Assistant | 225200000X | Yes |
Addresses
Primary practice location
67 Grace Street
Justice, WV 24851
Mailing address
67 Grace Street
Justice, WV 24851
Phone (304) 928-3113
Other providers in Justice, WV
All providers in Justice, WV · Physical Therapy Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.