Provider Demographics
NPI:1245565399
Name:CAMPBELL, HEATHER (PT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 E ORCHARD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1731
Mailing Address - Country:US
Mailing Address - Phone:303-850-7717
Mailing Address - Fax:303-850-7517
Practice Address - Street 1:7120 E ORCHARD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-1731
Practice Address - Country:US
Practice Address - Phone:303-850-7717
Practice Address - Fax:303-850-7517
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist