Healthcare Provider Details

I. General information

NPI: 1194101386
Provider Name (Legal Business Name): TEODORICO HECKMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7452 ADMIRAL PEARY HWY STE 3
CRESSON PA
16630-1706
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 814-408-2092
  • Fax:
Mailing address:
  • Phone: 423-702-4389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT024682
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: