Provider Demographics
NPI:1225282171
Name:CHESLA, HEIDI (MPT)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:CHESLA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:EARNEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19119 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120
Mailing Address - Country:US
Mailing Address - Phone:443-844-7723
Mailing Address - Fax:
Practice Address - Street 1:19119 MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9065
Practice Address - Country:US
Practice Address - Phone:443-844-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist