Individual
BRIAN R SHIDEMANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
100 BRADFORD RD, STE 210, WEXFORD, PA 15090
(724) 940-2323
(724) 940-2340
Mailing address
100 BRADFORD RD, STE 210, WEXFORD, PA 15090-8485
(724) 602-0747
(724) 604-8022
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305208250
VA
225100000X
Physical Therapist
Primary
PT022955
PA
Other
Enumeration date
08/21/2013
Last updated
05/24/2018
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