Individual
KEN N WITTEBORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1105 PERRY HWY, PGH., PA 15237
(412) 369-9955
Mailing address
1105 PERRY HWY, PGH, PA 15237
(412) 369-9955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE005358L
PA
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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