Provider Demographics
NPI:1366045791
Name:HADLAND, HEATHER ELIZABETH (LMT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:HADLAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:HADLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIZ HADLAND
Mailing Address - Street 1:625 OVERLIN DR
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3232
Mailing Address - Country:US
Mailing Address - Phone:970-948-0425
Mailing Address - Fax:
Practice Address - Street 1:1121 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3801
Practice Address - Country:US
Practice Address - Phone:970-945-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0023679225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty