Provider Demographics
NPI:1255596730
Name:GRAHAM, HEATHER HELEN (DPT)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:HELEN
Last Name:GRAHAM
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:PO BOX 1020
Mailing Address - Street 2:RT 209
Mailing Address - City:KRESGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18333-1020
Mailing Address - Country:US
Mailing Address - Phone:610-681-3637
Mailing Address - Fax:610-681-6344
Practice Address - Street 1:ROUTE 209 BOX 1020
Practice Address - Street 2:WEST END PHYSICAL THERAPY INC
Practice Address - City:KRESGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:18333-1020
Practice Address - Country:US
Practice Address - Phone:610-681-3637
Practice Address - Fax:610-681-6344
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist