Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PTH5376 | AL |
NPI | 1225289671 |
---|---|
Provider Name | Dr. Jill Elaine Heitzman |
First Address | Auburn, AL 36830-1903 |
Second Address | Opelika, AL 36801-5452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2008 |
Last Update Date | 19/10/2010 |