Provider Demographics
NPI:1548402605
Name:SCHELLLHORN, HEATHER LYNN (ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN
Last Name:SCHELLLHORN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N PAGE ST
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:IA
Mailing Address - Zip Code:52159-8236
Mailing Address - Country:US
Mailing Address - Phone:319-213-0604
Mailing Address - Fax:319-377-7621
Practice Address - Street 1:5264 COUNCIL ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2471
Practice Address - Country:US
Practice Address - Phone:319-398-6020
Practice Address - Fax:319-398-5453
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0006552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer