Provider Demographics
NPI:1639969447
Name:MALBURG, HEIDI (PTA)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:MALBURG
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 ASCOT DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8911
Mailing Address - Country:US
Mailing Address - Phone:513-600-6568
Mailing Address - Fax:
Practice Address - Street 1:1200 GLENDALE MILFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1209
Practice Address - Country:US
Practice Address - Phone:513-733-3370
Practice Address - Fax:513-733-3370
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant