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NPI Code Detail

MEDICARE: AMANDA HECK DPT

MEDICARE: AMANDA HECK DPT
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 TherapistPTP-PT-LIC-19379MT

General Provider Information

NPI Number : 1760922009
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA HECK DPT
Provider Business Mailing Address
First Line : PO BOX 711185
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84171-1185
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1411 MAIN ST STE D
Second Line :
City : BILLINGS
State : MT
Zip : 59105-1712
Country : US
Telephone Number : 406-206-6888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2017
Last Update Date : 08/27/2020

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