Provider Demographics
NPI:1053741868
Name:WATRING, VANESSA S (DPT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:S
Last Name:WATRING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:NOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:150 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1141
Mailing Address - Country:US
Mailing Address - Phone:304-329-1400
Mailing Address - Fax:304-329-1175
Practice Address - Street 1:37 MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525
Practice Address - Country:US
Practice Address - Phone:304-379-7678
Practice Address - Fax:304-379-4937
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 003248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist