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General NPI Number Information
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NPI Number | 1073925566
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Entity Type | Organization
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Legal Business Name | HEP LLC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 835 MERITA ST
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City | MOUNT AIRY
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State | NC
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Zip | 27030-2763
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Country | US
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Telephone | 336-755-2158
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Fax |
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Provider Business Mailing Address
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Address Line | 835 MERITA ST
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City | MOUNT AIRY
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State | NC
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Zip | 27030-2763
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Country | US
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Telephone | 336-755-2158
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANE JANE MILHAN
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Credential | DPT, PHD, DOAM
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Telephone | 336-755-2158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P13423
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License Number State | NC
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