Provider Demographics
NPI:1669667515
Name:HEUS, VIRIGINIA MOLONEY
Entity Type:Individual
Prefix:MS
First Name:VIRIGINIA
Middle Name:MOLONEY
Last Name:HEUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GINGER
Other - Middle Name:MOLONEY
Other - Last Name:HEUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:130 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2883
Mailing Address - Country:US
Mailing Address - Phone:920-729-3100
Mailing Address - Fax:920-720-7350
Practice Address - Street 1:130 2ND ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2883
Practice Address - Country:US
Practice Address - Phone:920-729-3100
Practice Address - Fax:920-720-7350
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4360024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist