MEDICARE: DR. HEATHER H CHAVEZ PT, DHS

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	225100000X	Physical Therapist	5501009406	MI

General Provider Information

NPI Number	:	1083683312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER H CHAVEZ PT, DHS

Provider Business Mailing Address
First Line	:	789 CAMBRIDGE DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2315
Country	:	US
Telephone Number	:	810-706-1860
Fax Number	:

Provider Business Practice Location Address
First Line	:	3069 UNIVERSITY DR
Second Line	:	SUITE 230
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-2324
Country	:	US
Telephone Number	:	248-276-6700
Fax Number	:

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/08/2007

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