Provider Demographics
NPI:1033176540
Name:VOLKER, HEATHER JOY (MSPT, MBA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:JOY
Last Name:VOLKER
Suffix:
Gender:F
Credentials:MSPT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 OWEN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LORETTO
Mailing Address - State:MN
Mailing Address - Zip Code:55357-9713
Mailing Address - Country:US
Mailing Address - Phone:763-520-0579
Mailing Address - Fax:763-520-0355
Practice Address - Street 1:6825 OWEN ST STE 101
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:MN
Practice Address - Zip Code:55357-9713
Practice Address - Country:US
Practice Address - Phone:763-520-0579
Practice Address - Fax:763-520-0355
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6400785OtherMEDICA
MN86D31V0OtherBCBS MINNESOTA
HP41182OtherHEALTH PARTNERS