Provider Demographics
NPI:1134635121
Name:HEGGE, AUBREY (DPT)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:HEGGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18421-1418
Mailing Address - Country:US
Mailing Address - Phone:570-785-2018
Mailing Address - Fax:
Practice Address - Street 1:103 SPRUCE ST STE 101
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1149
Practice Address - Country:US
Practice Address - Phone:570-226-7303
Practice Address - Fax:570-226-7303
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATPT021993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist