Provider Demographics
NPI:1629551387
Name:HESSEE, VICTORIA LEA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LEA
Last Name:HESSEE
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 1:132 RUNNING DEER
Mailing Address - Street 2:
Mailing Address - City:ROYAL
Mailing Address - State:AR
Mailing Address - Zip Code:71968-9775
Mailing Address - Country:US
Mailing Address - Phone:361-946-5068
Mailing Address - Fax:
Practice Address - Street 1:615 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:AR
Practice Address - Zip Code:71943-9061
Practice Address - Country:US
Practice Address - Phone:870-356-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4024225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant