Provider Demographics
NPI:1073532347
Name:WENDELL, HEATHER LEIGH (PT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEIGH
Last Name:WENDELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43086-0144
Mailing Address - Country:US
Mailing Address - Phone:614-890-3676
Mailing Address - Fax:614-890-2952
Practice Address - Street 1:839 FORTUNEGATE DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3521
Practice Address - Country:US
Practice Address - Phone:614-890-3676
Practice Address - Fax:614-890-2952
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist