Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1318435 | TX |
NPI | 1104483106 |
---|---|
Provider Name | Dr. Nancy Heuer |
First Address | Minneapolis, MN 55407-2284 |
Second Address | Springdale, AR 72764-7343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2019 |
Last Update Date | 24/05/2019 |