Healthcare Provider Details

I. General information

NPI: 1366550741
Provider Name (Legal Business Name): BARBARA ANN WETZEL R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BUTLER AVE
MARTINSBURG WV
25401-9990
US

IV. Provider business mailing address

7541 BLACK RD
THURMONT MD
21788-1004
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-0811
  • Fax:
Mailing address:
  • Phone: 301-271-7538
  • Fax: 304-260-4860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDOO150
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: