Provider Demographics
NPI:1811949043
Name:ATTADGIE, WENDY B (DC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:B
Last Name:ATTADGIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 KNOWLES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4102
Mailing Address - Country:US
Mailing Address - Phone:215-355-9337
Mailing Address - Fax:
Practice Address - Street 1:654 KNOWLES AVE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4102
Practice Address - Country:US
Practice Address - Phone:215-355-9337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003924L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
577725OtherHIGHMARK
U01466Medicare UPIN
577725OtherHIGHMARK