Healthcare Provider Details

I. General information

NPI: 1386956902
Provider Name (Legal Business Name): HEIDI L WULFF PLUMB GRAHAM DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI L WULFF PLUMB DPT

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10355 N LA CANADA DR STE 125
ORO VALLEY AZ
85737-7307
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 520-822-8640
  • Fax: 520-822-8641
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-31259
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: