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Individual

AMY SUZANNE WESOLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 231-8772
(717) 231-8435
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA055944
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103145793
PA
Enumeration date
12/31/2012
Last updated
01/23/2021
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