Provider Demographics
NPI:1417556937
Name:EGGERLING, HEIDI GEAN (LMT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:GEAN
Last Name:EGGERLING
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 1:13350 S POINT DR APT 11107
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8006
Mailing Address - Country:US
Mailing Address - Phone:774-400-9935
Mailing Address - Fax:
Practice Address - Street 1:13350 S POINT DR APT 11107
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8006
Practice Address - Country:US
Practice Address - Phone:774-400-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9125225700000X
UT13151435-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist