Provider Demographics
NPI:1760884472
Name:CHANDLER, HEIDI FLEMING (LMT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:FLEMING
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2317
Mailing Address - Country:US
Mailing Address - Phone:231-922-9622
Mailing Address - Fax:231-922-9621
Practice Address - Street 1:1213 W FRONT ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684
Practice Address - Country:US
Practice Address - Phone:231-922-9622
Practice Address - Fax:231-922-9621
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501000870172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist