Provider Demographics
NPI:1669748059
Name:HEDIN, JOHN A (MS PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:HEDIN
Suffix:
Gender:M
Credentials:MS PT
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Mailing Address - Street 1:3098 HEALY DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1432
Mailing Address - Country:US
Mailing Address - Phone:336-782-1971
Mailing Address - Fax:336-448-0212
Practice Address - Street 1:648 ALMONDRIDGE DR
Practice Address - Street 2:
Practice Address - City:RURAL HALL
Practice Address - State:NC
Practice Address - Zip Code:27045-9887
Practice Address - Country:US
Practice Address - Phone:336-969-0510
Practice Address - Fax:336-969-0511
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCP12365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist