Provider Demographics
NPI:1982362661
Name:WARMINGHAM, MAXWELL EDWIN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:EDWIN
Last Name:WARMINGHAM
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 1:112 BITTERSWEET PATH
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9658
Mailing Address - Country:US
Mailing Address - Phone:717-464-1338
Mailing Address - Fax:
Practice Address - Street 1:203 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-9020
Practice Address - Country:US
Practice Address - Phone:717-786-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist