Provider Demographics
NPI:1992847636
Name:HARSHMAN-TURK, HEATHER A (DPT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:A
Last Name:HARSHMAN-TURK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 LAHMEYER RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-5676
Mailing Address - Country:US
Mailing Address - Phone:260-432-4700
Mailing Address - Fax:260-459-9262
Practice Address - Street 1:2516 E. DUPONT ROAD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825
Practice Address - Country:US
Practice Address - Phone:260-490-4800
Practice Address - Fax:260-497-8399
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009029A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4423623OtherAETNA
IN000000487429OtherANTHEM BCBS
IN1424OtherPHYSICAN'S HEALTH PLAN
IN200838190AMedicaid
IN200838190AMedicaid