Provider Demographics
NPI:1003255894
Name:SARTORIUS, HEIDI GAIL (ATC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:GAIL
Last Name:SARTORIUS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-1827
Mailing Address - Country:US
Mailing Address - Phone:319-290-8694
Mailing Address - Fax:
Practice Address - Street 1:2820 HPER CTR
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57007-4003
Practice Address - Country:US
Practice Address - Phone:605-688-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD04162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer