Provider Demographics
NPI:1457913667
Name:NEY, HEATHER (PTA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:NEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CATALINA AVE
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-3318
Mailing Address - Country:US
Mailing Address - Phone:570-606-7217
Mailing Address - Fax:
Practice Address - Street 1:515 OHIO ST
Practice Address - Street 2:
Practice Address - City:WAKONDA
Practice Address - State:SD
Practice Address - Zip Code:57073-2013
Practice Address - Country:US
Practice Address - Phone:605-267-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant