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General NPI Number Information
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NPI Number | 1114834991
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Entity Type | Individual
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Provider Name | HEIDI PATRICIA CAMPION PTA
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 626 E SLIFER ST
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City | PORTAGE
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State | WI
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Zip | 53901-1224
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Country | US
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Telephone | 608-745-5400
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Fax |
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Provider Business Mailing Address
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Address Line | N4979 BEACH GARDEN RD
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City | POYNETTE
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State | WI
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Zip | 53955-9747
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Country | US
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Telephone | 608-513-7306
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 286-19
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License Number State | WI
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