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Individual

MR. WAYNE BARRY WERMUTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MED

Contact information

Practice address
1145 CLEARWOOD DR, ALLENTOWN, PA 18103-5405
(610) 821-8866
(610) 366-1960
Mailing address
1145 CLEARWOOD DR, ALLENTOWN, PA 18103-5405
(610) 821-8866
(610) 366-1960

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PF-00106-L
PA
103T00000X
Psychologist
Primary
PS-001275-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03101301
CAPITAL ADVANTAGE INS. CO
PA
Enumeration date
11/08/2006
Last updated
07/08/2007
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