Provider Demographics
NPI:1588617153
Name:HEARTSMART REHABILITATION, PLLC
Entity Type:Organization
Organization Name:HEARTSMART REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-695-6913
Mailing Address - Street 1:13125 N LA MONTANA DR
Mailing Address - Street 2:STE. A-B
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-3781
Mailing Address - Country:US
Mailing Address - Phone:210-831-2196
Mailing Address - Fax:
Practice Address - Street 1:13125 N LA MONTANA DR
Practice Address - Street 2:STE. A-B
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3781
Practice Address - Country:US
Practice Address - Phone:480-695-6913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty