Individual
KAYLA WERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-2176
Mailing address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-2176
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054363
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA054363
123456
PA
Enumeration date
06/09/2010
Last updated
03/02/2018
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