Provider Demographics
NPI:1063914646
Name:HEPPER, HEATHER (PT, DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HEPPER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 E 13 MILE RD APT 302
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5019
Mailing Address - Country:US
Mailing Address - Phone:989-245-0539
Mailing Address - Fax:
Practice Address - Street 1:10483 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442
Practice Address - Country:US
Practice Address - Phone:810-771-7686
Practice Address - Fax:810-771-7685
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist