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General NPI Number Information
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NPI Number | 1962805515
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Entity Type | Organization
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Legal Business Name | HEIDI'S THERAPY PLC
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 1232 EXCHANGE ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1184
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Country | US
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Telephone | 802-989-1462
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Fax | 888-965-0850
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Provider Business Mailing Address
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Address Line | 3873 CASE ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-8662
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Country | US
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Telephone | 802-989-1462
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Fax | 888-965-0850
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Authorized Official
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Title or Position | OWNER/MANAGER/PHYSICAL THERAPIST
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Name | HEIDI WILHELM
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Credential | PT, DPT
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Telephone | 802-989-1462
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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 | 040.0003639
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License Number State | VT
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