Provider Demographics
NPI:1962962902
Name:OXENREIDER, VALERIE JEANNE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEANNE
Last Name:OXENREIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 E WESNER RD
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9745
Mailing Address - Country:US
Mailing Address - Phone:610-944-5574
Mailing Address - Fax:
Practice Address - Street 1:1175 MOSSER RD
Practice Address - Street 2:
Practice Address - City:TREXLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18087-9650
Practice Address - Country:US
Practice Address - Phone:610-395-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000977208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation