| Doctor Name: | MR. DREW ERIC WIDING |
| NPI Number: | 1639166630 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT-005370 |
| Business Practice Address: | 2800 Q St Bldg 824 Wpafb, OH - 454337947 |
| Business Phone Number: | 9372551236 |
| Business Fax Number: | |
| Mailing Address: | 1801 Burgundy Ln, DAYTON |
| State: | OH |
| Postal Code: | 454593401 |
| Phone Number: | 9372911931 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT-005370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |