Provider Demographics
NPI:1275811069
Name:WESLEY, HEIDI ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:WESLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 E SHEA BLVD STE 168
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4686
Mailing Address - Country:US
Mailing Address - Phone:480-483-1025
Mailing Address - Fax:480-483-1026
Practice Address - Street 1:5040 E SHEA BLVD STE 168
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4686
Practice Address - Country:US
Practice Address - Phone:480-483-1025
Practice Address - Fax:480-483-1026
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist