Provider Demographics
NPI:1881673325
Name:LEVANDER, HEATHER RYAN (MPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RYAN
Last Name:LEVANDER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HICKLE ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4350
Mailing Address - Country:US
Mailing Address - Phone:724-437-9871
Mailing Address - Fax:724-437-4333
Practice Address - Street 1:75 HICKLE ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4350
Practice Address - Country:US
Practice Address - Phone:724-437-9871
Practice Address - Fax:724-437-4333
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP82597Medicare UPIN
PA067733SP8Medicare ID - Type Unspecified