Provider Demographics
NPI:1174959290
Name:VEITZ, DOMENICA ANNE (DPT, PCS)
Entity type:Individual
Prefix:DR
First Name:DOMENICA
Middle Name:ANNE
Last Name:VEITZ
Suffix:
Gender:F
Credentials:DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8248 WEYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-3532
Mailing Address - Country:US
Mailing Address - Phone:856-816-8615
Mailing Address - Fax:
Practice Address - Street 1:8248 WEYMOUTH DR
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-3532
Practice Address - Country:US
Practice Address - Phone:856-816-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist