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NPI Code Detail

MEDICARE: AMY D HEATHFIELD OTR

MEDICARE: AMY D HEATHFIELD OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5201005483MI

General Provider Information

NPI Number : 1083690697
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY D HEATHFIELD OTR
Provider Business Mailing Address
First Line : 653 EAST ST
Second Line :
City : COOPERSVILLE
State : MI
Zip : 49404-1132
Country : US
Telephone Number : 616-212-1227
Fax Number :
Provider Business Practice Location Address
First Line : 25 CONRAN DR
Second Line :
City : COOPERSVILLE
State : MI
Zip : 49404-1366
Country : US
Telephone Number : 616-997-6172
Fax Number : 616-997-6178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 07/08/2007

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Directions to “ AMY D HEATHFIELD OTR” Practice Location

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