Provider Demographics
NPI:1164077798
Name:PLOTZKE, HEIDI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:PLOTZKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:52900 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-3573
Mailing Address - Country:US
Mailing Address - Phone:586-991-1399
Mailing Address - Fax:586-218-3111
Practice Address - Street 1:52900 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-3573
Practice Address - Country:US
Practice Address - Phone:586-991-1399
Practice Address - Fax:586-218-3111
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010192292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic