MEDICARE: MR. WILLIAM A WERNER PT

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	2251X0800X	Orthopedic Physical Therapist	PT016632	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT016632	OTHER	PA	PHYSICAL THERAPY

General Provider Information

NPI Number	:	1285696252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM A WERNER PT

Provider Business Mailing Address
First Line	:	259 TIMBER VIEW DR
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-3994
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 CHAMBERS HILL RD
Second Line	:	SUITE C
City	:	HARRISBURG
State	:	PA
Zip	:	17111-2505
Country	:	US
Telephone Number	:	717-558-4333
Fax Number	:

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	07/08/2007

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