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General NPI Number Information
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NPI Number | 1417781725
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Entity Type | Individual
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Provider Name | ANTONIO HEIGHTER
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Gender | Male
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 2211 LAKE CLUB DR STE 105
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City | COLUMBUS
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State | OH
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Zip | 43232-3204
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Country | US
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Telephone | 614-704-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 5314 GATEHOUSE DR APT B
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City | WHITEHALL
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State | OH
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Zip | 43213-4525
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Country | US
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Telephone | 614-843-9872
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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