Provider Demographics
NPI:1851783823
Name:DILLOW, HEATHER TUCK (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:TUCK
Last Name:DILLOW
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:NICHOLE
Other - Last Name:TUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9268 HANOVER CROSSING DR
Mailing Address - Street 2:APT H
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3927
Mailing Address - Country:US
Mailing Address - Phone:804-316-7806
Mailing Address - Fax:
Practice Address - Street 1:9268 HANOVER CROSSING DR
Practice Address - Street 2:APT H
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3927
Practice Address - Country:US
Practice Address - Phone:804-316-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603792225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant