Provider Demographics
NPI:1578025037
Name:MESSER, HEIDI MICHELLE (PT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MICHELLE
Last Name:MESSER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MICHELLE
Other - Last Name:DELONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:154 REX RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:OH
Mailing Address - Zip Code:44849-9606
Mailing Address - Country:US
Mailing Address - Phone:937-578-8413
Mailing Address - Fax:
Practice Address - Street 1:990 S PROSPECT ST STE 4
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6283
Practice Address - Country:US
Practice Address - Phone:740-387-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist