Provider Demographics
NPI:1336661776
Name:HEIL, CASSANDRA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:
Last Name:HEIL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6391 OTTER RD
Mailing Address - Street 2:
Mailing Address - City:MOUND
Mailing Address - State:MN
Mailing Address - Zip Code:55364-9440
Mailing Address - Country:US
Mailing Address - Phone:952-412-5535
Mailing Address - Fax:
Practice Address - Street 1:8100 MEDICINE LAKE RD
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-3404
Practice Address - Country:US
Practice Address - Phone:763-544-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist