Provider Demographics
NPI:1669737151
Name:YANDZIAK, HEATHER JANE (DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JANE
Last Name:YANDZIAK
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 1:534 N 35TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3184
Mailing Address - Country:US
Mailing Address - Phone:252-726-1802
Mailing Address - Fax:252-726-1805
Practice Address - Street 1:534 N 35TH ST STE D
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3184
Practice Address - Country:US
Practice Address - Phone:252-726-1802
Practice Address - Fax:252-726-1805
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA225100000X
NCP18521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist