Healthcare Provider Details

I. General information

NPI: 1881402444
Provider Name (Legal Business Name): EMI H HEISTERKAMP DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12110 PECOS ST STE 250
WESTMINSTER CO
80234-2047
US

IV. Provider business mailing address

1350 40TH ST UNIT 718
DENVER CO
80205-5476
US

V. Phone/Fax

Practice location:
  • Phone: 720-542-8737
  • Fax:
Mailing address:
  • Phone: 858-449-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0020251
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: