Provider Demographics
NPI:1013615939
Name:VANDER WEIT, TY (DPT)
Entity type:Individual
Prefix:
First Name:TY
Middle Name:
Last Name:VANDER WEIT
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 1:7770 BRECKSVILLE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1074
Mailing Address - Country:US
Mailing Address - Phone:440-630-9263
Mailing Address - Fax:440-630-9058
Practice Address - Street 1:7770 BRECKSVILLE RD STE 3
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1074
Practice Address - Country:US
Practice Address - Phone:440-630-9263
Practice Address - Fax:440-630-9058
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist