Provider Demographics
NPI:1124509443
Name:HOTTINGER, HEATHER REAGAN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:REAGAN
Last Name:HOTTINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 JONATHAN LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1714
Mailing Address - Country:US
Mailing Address - Phone:740-644-7785
Mailing Address - Fax:
Practice Address - Street 1:894 JONATHAN LN
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1714
Practice Address - Country:US
Practice Address - Phone:740-644-7785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer