Healthcare Provider Details

I. General information

NPI: 1548204563
Provider Name (Legal Business Name): REBECCA WENRICH MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA MACHAMER MSPT

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 EVELYN DR
MILLERSBURG PA
17061-1258
US

IV. Provider business mailing address

8152 ROUTE 25
SPRING GLEN PA
17978-9524
US

V. Phone/Fax

Practice location:
  • Phone: 717-692-4708
  • Fax: 717-692-5464
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015023
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: