Provider Demographics
NPI:1932477619
Name:HEITMAN, NATASHA VALERIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:VALERIE
Last Name:HEITMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 MASSACHUSETTS AVE
Mailing Address - Street 2:STE 101D
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 MASSACHUSETTS AVE
Practice Address - Street 2:101D STUDIO 4
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-2959
Practice Address - Country:US
Practice Address - Phone:978-795-4066
Practice Address - Fax:978-224-1034
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist