Provider Demographics
NPI:1629281357
Name:WEIRICH, LINDA CARROLL (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CARROLL
Last Name:WEIRICH
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BLACK FRIAR RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1004
Mailing Address - Country:US
Mailing Address - Phone:610-525-3521
Mailing Address - Fax:610-525-3269
Practice Address - Street 1:773 E HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3837
Practice Address - Country:US
Practice Address - Phone:610-525-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 008321-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist