Provider Demographics
NPI:1962713214
Name:MACKEY, HEATHER EILEEN (DPT)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:EILEEN
Last Name:MACKEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:EILEEN
Other - Last Name:TARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:305 MEYERS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1020
Mailing Address - Country:US
Mailing Address - Phone:814-765-2351
Mailing Address - Fax:814-765-1095
Practice Address - Street 1:712 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1020
Practice Address - Country:US
Practice Address - Phone:814-765-2351
Practice Address - Fax:814-765-1095
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103765215-0001Medicaid