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NPI Code Detail

MEDICARE: ROBERT WIEGAND JR. D.P.T.

MEDICARE:   ROBERT  WIEGAND JR. D.P.T.
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
1225100000XPhysical TherapistPT018209PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WI1886723OTHERPAHIGHMARK BLUE SHIELD
22749209000OTHERPAINDEPENDENCE BLUE CROSS
350060610OTHERPACAPITAL BLUE CROSS/KHPC
444418OTHERPAHEATH AMER/HEALTH ASSUR
57735811OTHERPAAETNA

General Provider Information

NPI Number : 1366527723
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT WIEGAND JR. D.P.T.
Provider Business Mailing Address
First Line : 520 PHILADELPHIA ST
Second Line :
City : INDIANA
State : PA
Zip : 15701-3902
Country : US
Telephone Number : 724-463-7478
Fax Number : 724-463-0931
Provider Business Practice Location Address
First Line : 2605 EGYPT RD
Second Line : SUITE 104
City : TROOPER
State : PA
Zip : 19403-2317
Country : US
Telephone Number : 610-666-1702
Fax Number : 610-666-1726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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Directions to “ ROBERT WIEGAND JR. D.P.T.” Practice Location

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