Provider Demographics
NPI:1528220241
Name:WONSETTLER, CLIFTON N (DPT)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:N
Last Name:WONSETTLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WONSETTLER RD
Mailing Address - Street 2:
Mailing Address - City:SCENERY HILL
Mailing Address - State:PA
Mailing Address - Zip Code:15360-1831
Mailing Address - Country:US
Mailing Address - Phone:724-993-2728
Mailing Address - Fax:
Practice Address - Street 1:100 WONSETTLER RD.
Practice Address - Street 2:
Practice Address - City:SCENERY HILL
Practice Address - State:PA
Practice Address - Zip Code:15360
Practice Address - Country:US
Practice Address - Phone:724-993-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019445225100000X
WAPT60023302225100000X
PAPT019921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist