Provider Demographics
NPI:1154048635
Name:WEYRICH, GABRIELLE
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:WEYRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:STONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11429 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:THOMPSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17094-8682
Mailing Address - Country:US
Mailing Address - Phone:717-994-6259
Mailing Address - Fax:
Practice Address - Street 1:11429 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:THOMPSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17094-8682
Practice Address - Country:US
Practice Address - Phone:717-994-6259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer