Healthcare Provider Details

I. General information

NPI: 1528346418
Provider Name (Legal Business Name): HILLARY MILLICENT HEYLIGER L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18964 N DALE MABRY HWY SUITE 101
LUTZ FL
33548-4913
US

IV. Provider business mailing address

1308 AVONWOOD CT
LUTZ FL
33559-7902
US

V. Phone/Fax

Practice location:
  • Phone: 813-948-2107
  • Fax: 813-948-2790
Mailing address:
  • Phone: 813-541-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA57663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: