Provider Demographics
NPI:1477544062
Name:WEISMANTEL, ALAN R (PT)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:WEISMANTEL
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 1:961 FUHRMAN MILL RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9515
Mailing Address - Country:US
Mailing Address - Phone:717-632-3734
Mailing Address - Fax:
Practice Address - Street 1:136 PENN ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1928
Practice Address - Country:US
Practice Address - Phone:717-637-9214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002226L225100000X
TX1135168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA079976MV7Medicare PIN