MEDICARE: HEATHER MEANS PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	084058	IA

General Provider Information

NPI Number	:	1023810694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MEANS PTA

Provider Business Mailing Address
First Line	:	608 E 6TH ST APT 11
Second Line	:
City	:	VILLISCA
State	:	IA
Zip	:	50864-1246
Country	:	US
Telephone Number	:	712-621-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 14TH AVE
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-1159
Country	:	US
Telephone Number	:	712-621-0307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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Directions to “ HEATHER MEANS PTA” Practice Location

Language	Start Address	Practice Location

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