Provider Demographics
NPI:1700554995
Name:HEAP, DARCI (DPT)
Entity Type:Individual
Prefix:
First Name:DARCI
Middle Name:
Last Name:HEAP
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 1:261 TOWNSHIP ROAD 1400E
Mailing Address - Street 2:
Mailing Address - City:STRONGHURST
Mailing Address - State:IL
Mailing Address - Zip Code:61480-5469
Mailing Address - Country:US
Mailing Address - Phone:309-337-0009
Mailing Address - Fax:
Practice Address - Street 1:1401 W AGENCY RD
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1643
Practice Address - Country:US
Practice Address - Phone:319-752-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist