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NPI Code Detail

MEDICARE: TODD MATTHEW HEIKKINEN

MEDICARE: TODD MATTHEW HEIKKINEN
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
1225100000XPhysical Therapist
2225100000XPhysical Therapist5079WI

General Provider Information

NPI Number : 1437665544
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD MATTHEW HEIKKINEN
Provider Business Mailing Address
First Line : 1734 N WARREN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-1617
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1734 N WARREN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-1617
Country : US
Telephone Number : 414-467-6284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2017
Last Update Date : 12/27/2017

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Directions to “ TODD MATTHEW HEIKKINEN ” Practice Location

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