Healthcare Provider Details

I. General information

NPI: 1285183525
Provider Name (Legal Business Name): JAMES E HEIM PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 PEACHTREE RD STE 180
CHAMBLEE GA
30341-2312
US

IV. Provider business mailing address

5616 PEACHTREE RD STE 180
CHAMBLEE GA
30341-2312
US

V. Phone/Fax

Practice location:
  • Phone: 404-400-6242
  • Fax: 404-332-0308
Mailing address:
  • Phone: 404-400-6242
  • Fax: 404-332-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number22513
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: