Provider Demographics
NPI:1275816043
Name:GRIMMINGER, HEATHER KAY (PTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:KAY
Last Name:GRIMMINGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SHELLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3243
Mailing Address - Country:US
Mailing Address - Phone:814-949-7147
Mailing Address - Fax:
Practice Address - Street 1:220 NEWRY ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1626
Practice Address - Country:US
Practice Address - Phone:814-693-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1000087225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant