Provider Demographics
NPI:1093869422
Name:KOHLBUS, HEATHER ARLENE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ARLENE
Last Name:KOHLBUS
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 1:8 OVERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4510
Mailing Address - Country:US
Mailing Address - Phone:410-638-5162
Mailing Address - Fax:
Practice Address - Street 1:658 BOULTON ST STE A
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4214
Practice Address - Country:US
Practice Address - Phone:410-638-9400
Practice Address - Fax:410-638-9061
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer