Healthcare Provider Details

I. General information

NPI: 1982183364
Provider Name (Legal Business Name): MORGAN L. WEYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN L MERCER

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 EARLYSTOWN RD
CENTRE HALL PA
16828-9108
US

IV. Provider business mailing address

310 PENN ST STE 103
HOLLIDAYSBURG PA
16648-2044
US

V. Phone/Fax

Practice location:
  • Phone: 814-364-3290
  • Fax: 814-364-3295
Mailing address:
  • Phone: 814-364-3290
  • Fax: 814-364-3295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT027050
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: