Basic Information
| Provider Information | |||||||||
| NPI: | 1124543277 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WIEGER | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | LAUREN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2250 MILLENNIUM WAY STE 400 | ||||||||
| Address2: | |||||||||
| City: | ENOLA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170251488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177328131 | ||||||||
| FaxNumber: | 7177328132 | ||||||||
| Practice Location | |||||||||
| Address1: | 2250 MILLENNIUM WAY STE 400 | ||||||||
| Address2: | |||||||||
| City: | ENOLA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170251488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177328131 | ||||||||
| FaxNumber: | 7177328132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT026148 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.