Provider Demographics
NPI:1124374731
Name:PINER, HEATHER (PT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PINER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4503
Mailing Address - Country:US
Mailing Address - Phone:301-473-5945
Mailing Address - Fax:301-473-5901
Practice Address - Street 1:187 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 6
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4503
Practice Address - Country:US
Practice Address - Phone:301-473-5945
Practice Address - Fax:301-473-5901
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist