Provider Demographics
NPI:1841398195
Name:DUMAS, HEATHER L (PTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:DUMAS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 N 120TH ST
Mailing Address - Street 2:SUITE D8
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3479
Mailing Address - Country:US
Mailing Address - Phone:402-445-4335
Mailing Address - Fax:402-445-6162
Practice Address - Street 1:2085 N 120TH ST
Practice Address - Street 2:SUITE D8
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3479
Practice Address - Country:US
Practice Address - Phone:402-445-4335
Practice Address - Fax:402-445-6162
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE585225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant