Provider Demographics
NPI:1235691429
Name:WHATMORE, ANTHONY ROBERT (PT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROBERT
Last Name:WHATMORE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5269 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-2341
Mailing Address - Country:US
Mailing Address - Phone:814-833-4648
Mailing Address - Fax:
Practice Address - Street 1:2301 EDINBORO RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-3409
Practice Address - Country:US
Practice Address - Phone:814-860-7117
Practice Address - Fax:814-860-7157
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO17678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist