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Individual
MR. KEITH A WOBESER IV
Active
Individual
MR. KEITH A WOBESER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011767L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150818000
PERSONAL CHOICE PIN
PA
01
—
3204065
AETNA HMO PROVIDER #
PA
01
—
7680482
AETNA TRADITIONAL PROV. #
PA
01
—
P00433225
MEDICARE RAILROAD PIN
PA
01
—
WO1466561
BC/BS PROVIDER #
PA
Enumeration date
04/19/2006
Last updated
02/27/2008
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