Healthcare Provider Details

I. General information

NPI: 1881448330
Provider Name (Legal Business Name): TRYSTAN WERTLEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LUCY AVE
HUMMELSTOWN PA
17036-9134
US

IV. Provider business mailing address

125 LUCY AVE
HUMMELSTOWN PA
17036-9134
US

V. Phone/Fax

Practice location:
  • Phone: 717-915-7877
  • Fax: 717-323-6838
Mailing address:
  • Phone: 717-915-7877
  • Fax: 717-323-6838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC0119200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: