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Individual

GARY VAN WERTMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
626 WATER STREET, SUITE 1, ORBISONIA, PA 17243
(814) 447-5556
(814) 447-5682
Mailing address
PO BOX 40, ORBISONIA, PA 17243
(814) 447-5556
(814) 447-5682

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DOOS005169L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008434780002
PA
Enumeration date
03/17/2006
Last updated
07/08/2007
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