Provider Demographics
NPI:1144636200
Name:WYBERG, GARIN (PT, DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:GARIN
Middle Name:
Last Name:WYBERG
Suffix:
Gender:M
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALLEGHENY CTR FL 7
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5255
Mailing Address - Country:US
Mailing Address - Phone:412-330-5068
Mailing Address - Fax:
Practice Address - Street 1:1013 WEXFORD PLAZA DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9214
Practice Address - Country:US
Practice Address - Phone:724-934-2440
Practice Address - Fax:724-934-2442
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0249362251S0007X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports