Healthcare Provider Details

I. General information

NPI: 1528033024
Provider Name (Legal Business Name): HEATHER KATHLEEN BRIGGS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 ROUTE 38 WEST SUITE 5
LUMBERTON NJ
08048
US

IV. Provider business mailing address

20 PICKWICK DR
MARLTON NJ
08053-3817
US

V. Phone/Fax

Practice location:
  • Phone: 609-261-5656
  • Fax: 609-261-6432
Mailing address:
  • Phone: 856-396-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA009590
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: