Provider Demographics
NPI:1497142640
Name:WHITING, WENDY ELIZABETH (PTA)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ELIZABETH
Last Name:WHITING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-4230
Mailing Address - Country:US
Mailing Address - Phone:508-726-6170
Mailing Address - Fax:
Practice Address - Street 1:10 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2900
Practice Address - Country:US
Practice Address - Phone:508-473-6414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA724225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant