Provider Demographics
NPI:1851829600
Name:SELLERS, VANESSA MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:NIEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3347 W 12TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3725
Mailing Address - Country:US
Mailing Address - Phone:814-833-2022
Mailing Address - Fax:814-838-1223
Practice Address - Street 1:4500 PINE AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-2316
Practice Address - Country:US
Practice Address - Phone:814-825-8900
Practice Address - Fax:814-825-7599
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025504225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist