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General NPI Number Information
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NPI Number | 1659566461
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Entity Type | Organization
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Legal Business Name | LINDA P HEINZELMAN PTPC
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 484 GLEN ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-2976
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Country | US
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Telephone | 518-798-1269
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Fax | 518-792-9095
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Provider Business Mailing Address
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Address Line | 484 GLEN ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-2976
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Country | US
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Telephone | 518-798-1269
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Fax | 518-792-9095
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDA P HEINZELMAN
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Credential | PT
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Telephone | 518-798-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 004509-1
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License Number State | NY
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