Provider Demographics
NPI:1073660791
Name:BRUMMETT, HEATHER CHOWANIEC (PT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CHOWANIEC
Last Name:BRUMMETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:CHOWANIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12940 W CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5184
Mailing Address - Country:US
Mailing Address - Phone:623-536-5743
Mailing Address - Fax:
Practice Address - Street 1:12940 W CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-5184
Practice Address - Country:US
Practice Address - Phone:623-536-5743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist