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NPI Code Detail

MEDICARE: HEATHER WATTERS DPT

MEDICARE: HEATHER WATTERS DPT
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
1225100000XPhysical Therapist13049OH

General Provider Information

NPI Number : 1174077937
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER WATTERS DPT
Provider Business Mailing Address
First Line : 7390 OLD OAK BLVD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3328
Country : US
Telephone Number : 440-816-8010
Fax Number : 440-816-4850
Provider Business Practice Location Address
First Line : 7390 OLD OAK BLVD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3328
Country : US
Telephone Number : 440-816-8010
Fax Number : 440-816-4850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2016
Last Update Date : 01/26/2017

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Directions to “ HEATHER WATTERS DPT” Practice Location

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