Provider Demographics
NPI:1366507816
Name:HEMMERICH, WILLIAM A (MPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:HEMMERICH
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-1900
Mailing Address - Country:US
Mailing Address - Phone:610-582-2348
Mailing Address - Fax:610-582-3938
Practice Address - Street 1:825 PARK RD
Practice Address - Street 2:
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9455
Practice Address - Country:US
Practice Address - Phone:610-944-9500
Practice Address - Fax:610-944-6748
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50029748OtherBLUE CROSS
PA1584233OtherBLUE SHIELD
PA50029748OtherBLUE CROSS