Provider Demographics
NPI:1578363701
Name:GENERATIONS R.C., INC.
Entity type:Organization
Organization Name:GENERATIONS R.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTAILING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-233-0753
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-0219
Mailing Address - Country:US
Mailing Address - Phone:681-233-0753
Mailing Address - Fax:304-208-8925
Practice Address - Street 1:100 MARSHALL ST N STE 2
Practice Address - Street 2:
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031-1041
Practice Address - Country:US
Practice Address - Phone:304-757-2500
Practice Address - Fax:304-757-2586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERATIONS R.C., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty