Provider Demographics
NPI:1922209477
Name:WESSMAN, HENRY CLAIR (PT)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:CLAIR
Last Name:WESSMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 SUNDANCE DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7296
Mailing Address - Country:US
Mailing Address - Phone:701-451-0123
Mailing Address - Fax:
Practice Address - Street 1:1594 SUNDANCE DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7296
Practice Address - Country:US
Practice Address - Phone:701-451-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND153225100000X
MN356225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist