Provider Demographics
NPI:1508143306
Name:AKINS, HEATHER MATAKO
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MATAKO
Last Name:AKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:MATAKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:164 WETHERBY LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4957
Mailing Address - Country:US
Mailing Address - Phone:614-841-3900
Mailing Address - Fax:614-841-3930
Practice Address - Street 1:164 WETHERBY LN
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4957
Practice Address - Country:US
Practice Address - Phone:614-841-3900
Practice Address - Fax:614-841-3930
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.013491225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist