Provider Demographics
NPI:1124089776
Name:SWEETMAN, HEIDI (MSPT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SWEETMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S COUNTY TRL STE A205
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-3540
Mailing Address - Country:US
Mailing Address - Phone:401-295-2374
Mailing Address - Fax:401-295-2370
Practice Address - Street 1:400 S COUNTY TRL STE A205
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:RI
Practice Address - Zip Code:02822-3540
Practice Address - Country:US
Practice Address - Phone:401-295-2374
Practice Address - Fax:401-295-2370
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410059OtherBLUECHIP PROVIDER NUMBER
RI7633548OtherAETNA PROVIDER NUMBER
RI27221-8OtherBCBS PROVIDER NUMBER
RI410059OtherBLUECHIP PROVIDER NUMBER