Provider Demographics
NPI:1013052265
Name:CHATT, HEATHER MICHELE (DPT, OCS, CERT MDT)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MICHELE
Last Name:CHATT
Suffix:
Gender:F
Credentials:DPT, OCS, CERT MDT
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:MICHELE
Other - Last Name:BAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, CERT MDT
Mailing Address - Street 1:604 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8414
Mailing Address - Country:US
Mailing Address - Phone:585-781-4510
Mailing Address - Fax:
Practice Address - Street 1:790 AYRAULT RD
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8981
Practice Address - Country:US
Practice Address - Phone:585-425-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist