Most Relevant Information
Provider Data
| NPI Number: | 1003595497 |
| Provider Name: | BETHANY GRACE COSGROVE LPTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 002867 |
Most Important Dates
| Enumeration Date: | 07/13/2023 |
| Last Updated: | 07/13/2023 |
Provider Practice Location
13857 APPLE HARVEST DR
MARTINSBURG
WV
254036199
Practice Location Phone/Fax
| Phone: | 3045968878 |
| Fax: |
Provider Mailing Location
992 HALLOWS WAY
GERRARDSTOWN
WV
254204382
Provider Mailing Phone/Fax
| Phone: | 3048865302 |
| Fax: |