MEDICARE: ASHLEY WERTMAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	28381	MD
2	225100000X	Physical Therapist	PT003904	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1174350292	OTHER	WV	NPI

General Provider Information

NPI Number	:	1013435668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY WERTMAN DPT

Provider Business Mailing Address
First Line	:	PO BOX 2000
Second Line	:
City	:	SHEPHERDSTOWN
State	:	WV
Zip	:	25443-2000
Country	:	US
Telephone Number	:	304-616-0013
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 W HIGH ST
Second Line	:
City	:	SHEPHERDSTOWN
State	:	WV
Zip	:	25443-7700
Country	:	US
Telephone Number	:	304-616-0013
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	12/11/2024

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