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NPI Code Detail

MEDICARE: KEITH WEBBER ATC

MEDICARE:   KEITH  WEBBER  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1558803940
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH WEBBER ATC
Provider Business Mailing Address
First Line : 201 MONROE ST
Second Line :
City : EDINBORO
State : PA
Zip : 16412-2030
Country : US
Telephone Number : 814-449-1845
Fax Number :
Provider Business Practice Location Address
First Line : 109 UNIVERSITY SQ
Second Line :
City : ERIE
State : PA
Zip : 16541-0002
Country : US
Telephone Number : 814-871-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2016
Last Update Date : 11/16/2016

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Directions to “ KEITH WEBBER ATC” Practice Location

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