Provider Demographics
NPI:1821697442
Name:SPADOLA, HEATHER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SPADOLA
Suffix:
Gender:F
Credentials:PT, DPT
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 45926
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-5926
Mailing Address - Country:US
Mailing Address - Phone:610-642-8837
Mailing Address - Fax:610-642-1607
Practice Address - Street 1:2895 HAMILTON BLVD
Practice Address - Street 2:STE102
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6172
Practice Address - Country:US
Practice Address - Phone:610-330-9740
Practice Address - Fax:610-432-4887
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028772208100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation