Provider Demographics
NPI:1700066271
Name:WERTMAN, NANCY A (MPT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:WERTMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:736 S ROUTE 183
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-8978
Mailing Address - Country:US
Mailing Address - Phone:570-739-0905
Mailing Address - Fax:
Practice Address - Street 1:736 S ROUTE 183
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-8978
Practice Address - Country:US
Practice Address - Phone:570-739-0905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006857L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist