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NPI Code Detail

MEDICARE: TAREN WEIDNER PTA

MEDICARE: TAREN WEIDNER PTA
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
1225200000XPhysical Therapy AssistantA4406MD
2225200000XPhysical Therapy AssistantTE1005260PA

General Provider Information

NPI Number : 1235597592
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAREN WEIDNER PTA
Provider Business Mailing Address
First Line : 60 ANDREWS LN
Second Line :
City : GLENMOORE
State : PA
Zip : 19343-2001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 TEL HAI CIR
Second Line :
City : HONEY BROOK
State : PA
Zip : 19344-1271
Country : US
Telephone Number : 610-273-9333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2016
Last Update Date : 06/02/2022

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