Provider Demographics
NPI:1659399855
Name:HEITZ, JULIE SUZANNE (OT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:SUZANNE
Last Name:HEITZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6031
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45270-6031
Mailing Address - Country:US
Mailing Address - Phone:513-557-4270
Mailing Address - Fax:513-557-3214
Practice Address - Street 1:560 S LOOP RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3405
Practice Address - Country:US
Practice Address - Phone:859-301-5600
Practice Address - Fax:859-301-5669
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT045062251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0922920Medicare PIN