Provider Demographics
NPI:1174931497
Name:RESH, WAYNE (ATC)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:
Last Name:RESH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ALPINE RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-8531
Mailing Address - Country:US
Mailing Address - Phone:484-269-9244
Mailing Address - Fax:
Practice Address - Street 1:33 ALPINE RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-8531
Practice Address - Country:US
Practice Address - Phone:484-269-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer