Basic Information
Provider Information
NPI: 1922256973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRITZ
FirstName: WENDY
MiddleName:  
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Mailing Information
Address1: 2250 HICKORY RD
Address2: SUITE 240
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621047
CountryCode: US
TelephoneNumber: 6108341122
FaxNumber: 6106844547
Practice Location
Address1: 376 TAMARACK DR
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181044444
CountryCode: US
TelephoneNumber: 6103517007
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/03/2008
LastUpdateDate: 09/03/2008
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOC008199PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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