Provider Demographics
NPI:1548801798
Name:WEICHT, LENZIE
Entity Type:Individual
Prefix:
First Name:LENZIE
Middle Name:
Last Name:WEICHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 FITNESS LN
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-7080
Mailing Address - Country:US
Mailing Address - Phone:304-258-1300
Mailing Address - Fax:304-258-1400
Practice Address - Street 1:5724 HAMMONDS MILL RD STE G
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-6491
Practice Address - Country:US
Practice Address - Phone:304-274-0123
Practice Address - Fax:304-274-1819
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27690261QP2000X
WV004205261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy