Provider Demographics
NPI:1790413714
Name:WERRY, MASON (DPT)
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:WERRY
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 1:2944 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-1139
Mailing Address - Country:US
Mailing Address - Phone:412-605-4821
Mailing Address - Fax:
Practice Address - Street 1:100 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3428
Practice Address - Country:US
Practice Address - Phone:412-734-6030
Practice Address - Fax:412-734-6881
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030652225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty