Provider Demographics
NPI:1568991495
Name:GIESE, HEATHER DANIELLE (PTA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DANIELLE
Last Name:GIESE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 SMOKY PARK HWY
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8237
Mailing Address - Country:US
Mailing Address - Phone:828-508-3851
Mailing Address - Fax:
Practice Address - Street 1:516 WALL ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-5973
Practice Address - Country:US
Practice Address - Phone:828-452-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA2941225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant