Provider Demographics
NPI:1043596380
Name:HEIPLE, ZANE ABRAHAM (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:ZANE
Middle Name:ABRAHAM
Last Name:HEIPLE
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 VINE ST
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-7811
Mailing Address - Country:US
Mailing Address - Phone:724-467-0900
Mailing Address - Fax:
Practice Address - Street 1:95 VINE ST
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15717-7811
Practice Address - Country:US
Practice Address - Phone:724-467-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0042792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer