MEDICARE: MS. HEATHER ROURKE- SCHLUETER PT

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	2251X0800X	Orthopedic Physical Therapist	10822	CA

General Provider Information

NPI Number	:	1821271347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER ROURKE- SCHLUETER PT

Provider Business Mailing Address
First Line	:	5 UNDERHILL RD
Second Line	:
City	:	MILL VALLEY
State	:	CA
Zip	:	94941-1423
Country	:	US
Telephone Number	:	415-342-1430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BLACKFIELD DR
Second Line	:
City	:	TIBURON
State	:	CA
Zip	:	94920-2053
Country	:	US
Telephone Number	:	415-342-1430
Fax Number	:

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

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	04/27/2020

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