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General NPI Number Information
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NPI Number | 1518418383
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Entity Type | Individual
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Provider Name | HEIDI ZAMBRANO LMT
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Gender | Female
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 21016 S 80TH AVE
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City | FRANKFORT
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State | IL
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Zip | 60423-9203
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Country | US
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Telephone | 815-355-8009
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Fax |
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Provider Business Mailing Address
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Address Line | 21204 S PFEIFFER RD
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City | FRANKFORT
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State | IL
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Zip | 60423-8300
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.013025
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License Number State | IL
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