Provider Demographics
NPI:1740486695
Name:PADGETT, HEATHER RAE (PTA)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RAE
Last Name:PADGETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:RAE
Other - Last Name:HELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1765 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-2559
Mailing Address - Country:US
Mailing Address - Phone:319-358-7370
Mailing Address - Fax:
Practice Address - Street 1:3661 ROCHESTER AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9271
Practice Address - Country:US
Practice Address - Phone:319-351-7460
Practice Address - Fax:319-341-6229
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01115225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant