Provider Demographics
NPI:1154379402
Name:WEXLER, HOLLY BETH (MPT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:BETH
Last Name:WEXLER
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 1:126 S STATE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3524
Mailing Address - Country:US
Mailing Address - Phone:215-579-6991
Mailing Address - Fax:215-579-9774
Practice Address - Street 1:126 S STATE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3524
Practice Address - Country:US
Practice Address - Phone:215-579-6991
Practice Address - Fax:215-579-9774
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-0008212-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHIGHMARK BC/BSOther907969
PAINDEPENDENCE BCOther0349709000