Provider Demographics
NPI:1225193345
Name:HEJTMANEK, LAURA M (PT DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:HEJTMANEK
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:HADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2001 WESTOWN PKWY
Mailing Address - Street 2:STE 107
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1540
Mailing Address - Country:US
Mailing Address - Phone:515-440-3439
Mailing Address - Fax:515-440-3832
Practice Address - Street 1:516 NILE KINNICK DR. SOUTH
Practice Address - Street 2:STE B
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1831
Practice Address - Country:US
Practice Address - Phone:515-993-5599
Practice Address - Fax:515-993-1964
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03949225100000X
IA3949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist