Provider Demographics
NPI:1528178597
Name:WOOD, HEATHER RIMER (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RIMER
Last Name:WOOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 661495
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-1495
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:1310 ALFORD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3199
Practice Address - Country:US
Practice Address - Phone:205-824-8850
Practice Address - Fax:205-824-8853
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-25774OtherBLUE CROSS PROVIDER NUMBE
AL7498678OtherAETNA