Provider Demographics
NPI:1780841866
Name:HEDETNIEMI, MARK C (DPT)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:HEDETNIEMI
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:232 MITCHELL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-9412
Mailing Address - Country:US
Mailing Address - Phone:302-934-1500
Mailing Address - Fax:302-934-6628
Practice Address - Street 1:232 MITCHELL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-9412
Practice Address - Country:US
Practice Address - Phone:302-934-1500
Practice Address - Fax:302-934-6628
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2008-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEJ1-00017572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic