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Individual

CLYDE CHARLES WEYANDT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
10714 POTOMAC TENNIS LANE, POTOMAC, MD 20854
(301) 299-2273
Mailing address
523 21ST AVE, ALTOONA, PA 16601-4139
(814) 644-9922

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE007586
PA

Other

Enumeration date
12/27/2007
Last updated
12/27/2007
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