Provider Demographics
NPI:1306946835
Name:JEFFCOAT, HEATHER (PT, MPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JEFFCOAT
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:SUITE1110
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7915
Mailing Address - Country:US
Mailing Address - Phone:864-261-3099
Mailing Address - Fax:864-261-6617
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:SUITE1110
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7915
Practice Address - Country:US
Practice Address - Phone:864-261-3099
Practice Address - Fax:864-261-6617
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist