Provider Demographics
NPI:1154927317
Name:HEISS, CAROLINA ALCANTARA
Entity type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:ALCANTARA
Last Name:HEISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:CARMONA DE ALCANTARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 HILDRETH ST UNIT 21
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-1170
Mailing Address - Country:US
Mailing Address - Phone:978-221-0440
Mailing Address - Fax:
Practice Address - Street 1:101 AMESBURY ST STE 303
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1318
Practice Address - Country:US
Practice Address - Phone:978-975-0395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist