Provider Demographics
NPI:1932262532
Name:J DE HEER LLC
Entity type:Organization
Organization Name:J DE HEER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE HEER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:856-354-8040
Mailing Address - Street 1:125 BURNT MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3903
Mailing Address - Country:US
Mailing Address - Phone:856-354-8040
Mailing Address - Fax:856-354-8042
Practice Address - Street 1:125 BURNT MILL RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3903
Practice Address - Country:US
Practice Address - Phone:856-354-8040
Practice Address - Fax:856-354-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00632400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy