Provider Demographics
NPI:1457498222
Name:HEIDRICH, CARRIE TINDOL (DPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:TINDOL
Last Name:HEIDRICH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:TINDOL
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 OFFICE PARK CIR STE 217
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:3125 INDEPENDENCE DR STE 300B
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4168
Practice Address - Country:US
Practice Address - Phone:205-879-7501
Practice Address - Fax:205-879-0675
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4950225100000X
ALPT4950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH4950OtherPHYSICAL THERAPY LICENSE