MEDICARE: DR. MARY SHARON WERTH PT, 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	027386-1	NY

General Provider Information

NPI Number	:	1417155052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY SHARON WERTH PT, DPT

Provider Business Mailing Address
First Line	:	11 OAK ST
Second Line	:	UPPER APARTMENT
City	:	SILVER CREEK
State	:	NY
Zip	:	14136-1217
Country	:	US
Telephone Number	:	585-943-7083
Fax Number	:

Provider Business Practice Location Address
First Line	:	8505 ERIE RD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9703
Country	:	US
Telephone Number	:	716-549-1099
Fax Number	:	716-549-2293

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

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

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