Provider Demographics
NPI:1982183364
Name:WEYANT, MORGAN L
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:L
Last Name:WEYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:L
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 PENN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-364-3290
Mailing Address - Fax:814-364-3295
Practice Address - Street 1:2825 EARLYSTOWN RD
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9108
Practice Address - Country:US
Practice Address - Phone:814-364-3290
Practice Address - Fax:814-364-3295
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist