Healthcare Provider Details

I. General information

NPI: 1932597044
Provider Name (Legal Business Name): JANET HEPPNER-MCCONATHY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2014
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S STATE ST SUITE G
WESTERVILLE OH
43081-2039
US

IV. Provider business mailing address

100 S STATE ST SUITE G
WESTERVILLE OH
43081-2039
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-2219
  • Fax:
Mailing address:
  • Phone: 614-882-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.009135
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: