Provider Demographics
NPI:1306259536
Name:NORTH, HEATHER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:NORTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CENTURY CIR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1696
Mailing Address - Country:US
Mailing Address - Phone:720-722-0793
Mailing Address - Fax:
Practice Address - Street 1:245 CENTURY CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1696
Practice Address - Country:US
Practice Address - Phone:720-722-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist