Provider Demographics
NPI:1922408079
Name:HILDITCH, HEATHER ABBOT (LMT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ABBOT
Last Name:HILDITCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 W CENTRAL AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1499
Mailing Address - Country:US
Mailing Address - Phone:614-327-1640
Mailing Address - Fax:
Practice Address - Street 1:554 W CENTRAL AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1499
Practice Address - Country:US
Practice Address - Phone:614-327-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.009445 A-B172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist