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General NPI Number Information
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NPI Number | 1114187523
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Entity Type | Individual
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Provider Name | PAUL T HEINZMANN P.T., M.B.A.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 4480 MOUNT HOPE RD SUITE A
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City | WILLIAMSBURG
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State | MI
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Zip | 49690-9209
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Country | US
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Telephone | 231-938-2425
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Fax | 231-938-2453
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Provider Business Mailing Address
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Address Line | 4480 MOUNT HOPE RD SUITE A
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City | WILLIAMSBURG
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State | MI
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Zip | 49690-9209
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Country | US
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Telephone | 231-938-2425
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Fax | 231-938-2453
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5501002327
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License Number State | MI
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