Clyde Charles Weyandt JR., PTA

NPI #1497939383 in Potomac, Maryland

Provider Information

NPI Number: 1497939383
Entity Type: Individual
Name: Clyde Charles Weyandt JR., PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Dec 27, 2007
Last Updated: Dec 27, 2007

Practice Location

Address: 10714 POTOMAC TENNIS LANE
City: Potomac
State: Maryland
ZIP Code: 20854
Phone: (301) 299-2273

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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