Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Physical Therapy, LLC

Organization Early Intervention Provider Agency · NPI 1750657664

Pediatric Physical Therapy, LLC is an Early Intervention Provider Agency in Fairmont, West Virginia. Licensed in West Virginia. Registered with an NPI since 2012.

Licensed in
WV
In the registry since
2012
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

Rr 6 Box 260-6E
Fairmont, WV 26554-9396
Phone: (304) 367-0750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence 1046-0165 (WV)
Early Intervention Provider Agency Taxonomy 252Y00000X · Licence 1046-0165 (WV)

Record details

NPI number1750657664
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nancy Hickman — President · (304) 366-8395
NPI enumeratedMarch 25, 2012
Last updated in NPPESMarch 25, 2012
Mailing addressPo Box 88, Colfax, WV 26566-0088

Other providers in Fairmont