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NPI Code Detail

MEDICARE: MRS. SHARON LYNN HEITZ P.T.

MEDICARE:  MRS. SHARON LYNN HEITZ  P.T.
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
12251P0200XPediatric Physical Therapist5945CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215991724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON LYNN HEITZ P.T.
Provider Business Mailing Address
First Line : 4050 RESERVE PT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-1043
Country : US
Telephone Number : 719-337-7722
Fax Number : 719-685-5182
Provider Business Practice Location Address
First Line : 4050 RESERVE PT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-1043
Country : US
Telephone Number : 719-337-7722
Fax Number : 719-685-5182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 07/09/2007

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