Provider Demographics
NPI:1124543277
Name:WIEGER, DANIELLE LAUREN (DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LAUREN
Last Name:WIEGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 LINDLE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2428
Mailing Address - Country:US
Mailing Address - Phone:717-803-3342
Mailing Address - Fax:717-974-8743
Practice Address - Street 1:433 NORTH ENOLA RD
Practice Address - Street 2:SUITE B
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-2128
Practice Address - Country:US
Practice Address - Phone:717-305-1749
Practice Address - Fax:717-204-5566
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist