Healthcare Provider Details

I. General information

NPI: 1225150832
Provider Name (Legal Business Name): HEIDI SCHLITTLER-SMITH PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARK DR
WESTFORD MA
01886-3511
US

IV. Provider business mailing address

15A HIGH ST
PEPPERELL MA
01463-1617
US

V. Phone/Fax

Practice location:
  • Phone: 978-392-1144
  • Fax: 978-392-0032
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number7898
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: