Provider Demographics
NPI:1306084603
Name:HEIMAN GLEASON, KIM RENEE (PT, MSPT)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:RENEE
Last Name:HEIMAN GLEASON
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:HEIMAN
Other - Last Name:GLEASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, MSPT
Mailing Address - Street 1:9261 N 129TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-6232
Mailing Address - Country:US
Mailing Address - Phone:480-551-7050
Mailing Address - Fax:480-551-7050
Practice Address - Street 1:9261 N 129TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-6232
Practice Address - Country:US
Practice Address - Phone:480-551-7050
Practice Address - Fax:480-551-7050
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist