Provider Demographics
NPI:1275344731
Name:ART, HEATHER M (PTA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:ART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:18000 COVE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-1383
Mailing Address - Country:US
Mailing Address - Phone:616-847-1280
Mailing Address - Fax:616-847-1290
Practice Address - Street 1:2073 HOLTON ROAD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-1535
Practice Address - Country:US
Practice Address - Phone:231-744-0077
Practice Address - Fax:231-744-0030
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
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Provider Licenses
StateLicense IDTaxonomies
MI5502003515225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant