Provider Demographics
NPI:1730138348
Name:HEINE, MARCI M (PT)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:M
Last Name:HEINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARCI
Other - Middle Name:M
Other - Last Name:DYLLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2129
Mailing Address - Country:US
Mailing Address - Phone:605-334-5630
Mailing Address - Fax:605-335-2746
Practice Address - Street 1:1720 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2129
Practice Address - Country:US
Practice Address - Phone:605-334-5630
Practice Address - Fax:605-335-2746
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist