Provider Demographics
NPI:1659427714
Name:WESSELLS, WILLIAM ANDREW (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ANDREW
Last Name:WESSELLS
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 KARLSTAD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3581
Mailing Address - Country:US
Mailing Address - Phone:302-668-6863
Mailing Address - Fax:
Practice Address - Street 1:212 CARTER DR
Practice Address - Street 2:SUITE C
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5837
Practice Address - Country:US
Practice Address - Phone:302-378-7174
Practice Address - Fax:302-378-7157
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00002032255A2300X
PART0033532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer