Provider Demographics
NPI:1730639352
Name:WERTENBERGER, ERIN ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:WERTENBERGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 S GRACE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67154-9055
Mailing Address - Country:US
Mailing Address - Phone:316-734-6925
Mailing Address - Fax:
Practice Address - Street 1:1015 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-5735
Practice Address - Country:US
Practice Address - Phone:620-241-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist