Individual
DR. JEFFREY W WIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., ATC
Contact information
Practice address
115 PUCILLO DR, MILLERSVILLE, PA 17551-0302
(717) 871-5367
Mailing address
PO BOX 1002, MILLERSVILLE, PA 17551-0302
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000678A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
SPECIALIST/TECHNOLOGIST - ATHLETIC TRAINER
—
Enumeration date
09/14/2018
Last updated
09/14/2018
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