Provider Demographics
NPI:1396063715
Name:HAWKES, HEIDI
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:HAWKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAFRANCE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEARE
Mailing Address - State:NH
Mailing Address - Zip Code:03281
Mailing Address - Country:US
Mailing Address - Phone:603-529-7299
Mailing Address - Fax:
Practice Address - Street 1:25 HALL STREET
Practice Address - Street 2:SUITE 201 PROFESSIONAL PHYSICAL THERAPY SERVICES,LLC
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4819
Practice Address - Country:US
Practice Address - Phone:603-226-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0368225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant