Provider Demographics
NPI:1073663472
Name:WHETSEL, VERONICA LYNN (MPT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:LYNN
Last Name:WHETSEL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3895 HOMESTEAD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6989
Mailing Address - Country:US
Mailing Address - Phone:443-822-3725
Mailing Address - Fax:
Practice Address - Street 1:2152 RENARD CT
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-6756
Practice Address - Country:US
Practice Address - Phone:443-822-3725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20859225100000X
GAPT015629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist