Healthcare Provider Details

I. General information

NPI: 1235069121
Provider Name (Legal Business Name): NANCY WEITHOFER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 DICKINSON ST
SPRINGFIELD MA
01108-3168
US

IV. Provider business mailing address

461 PROSPECT ST
EAST LONGMEADOW MA
01028-3167
US

V. Phone/Fax

Practice location:
  • Phone: 413-739-4715
  • Fax:
Mailing address:
  • Phone: 413-374-8488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number8386
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: