Healthcare Provider Details

I. General information

NPI: 1184957144
Provider Name (Legal Business Name): CORINNA ANN HEFFELFINGER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SOUTH CHURCH ST
PHILADELPHIA PA
19106
US

IV. Provider business mailing address

235 SKI-VIEW DR
PALMERTON PA
18071
UM

V. Phone/Fax

Practice location:
  • Phone: 215-238-9848
  • Fax: 800-974-4241
Mailing address:
  • Phone: 610-826-4885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE100260
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: