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NPI Code Detail

MEDICARE: CASEY HART HEINLE

MEDICARE: CASEY HART HEINLE
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1982199931
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY HART HEINLE
Provider Business Mailing Address
First Line : 990 RESERVE DR STE 250
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-1392
Country : US
Telephone Number : 866-564-3589
Fax Number : 866-350-6502
Provider Business Practice Location Address
First Line : 215 N LAMAR AVE
Second Line :
City : HAYSVILLE
State : KS
Zip : 67060-1266
Country : US
Telephone Number : 316-524-3211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2018
Last Update Date : 06/22/2018

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Directions to “ CASEY HART HEINLE ” Practice Location

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