Healthcare Provider Details

I. General information

NPI: 1316631617
Provider Name (Legal Business Name): HEATHER HAMMIL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 UNIVERSITY AVE # MC9430
MIDDLETON WI
53562-3036
US

IV. Provider business mailing address

4937 E COUNTY RD N
MILTON WI
53563-9236
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-8060
  • Fax: 608-262-7679
Mailing address:
  • Phone: 608-436-8195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16282-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: