Provider Demographics
NPI:1346681103
Name:MEIZINGER, HEIDI LYN (LMT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYN
Last Name:MEIZINGER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W BAY RD STE E
Mailing Address - Street 2:
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655-2447
Mailing Address - Country:US
Mailing Address - Phone:508-648-7490
Mailing Address - Fax:
Practice Address - Street 1:15 W BAY RD STE E
Practice Address - Street 2:
Practice Address - City:OSTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02655-2447
Practice Address - Country:US
Practice Address - Phone:508-648-7490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11399225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist