MEDICARE: MRS. KERRI SPENCE HEILMAN OTR/L

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
1	225X00000X	Occupational Therapist	0119003052	VA

General Provider Information

NPI Number	:	1639142045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KERRI SPENCE HEILMAN OTR/L

Provider Business Mailing Address
First Line	:	1388 LANETOWN RD
Second Line	:
City	:	CROZET
State	:	VA
Zip	:	22932-2811
Country	:	US
Telephone Number	:	434-216-4825
Fax Number	:

Provider Business Practice Location Address
First Line	:	1388 LANETOWN RD
Second Line	:
City	:	CROZET
State	:	VA
Zip	:	22932-2811
Country	:	US
Telephone Number	:	434-216-4825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	05/07/2022

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