Provider Demographics
NPI:1750560652
Name:GRUBB, HEIDI REBECCA (DPT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:REBECCA
Last Name:GRUBB
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:REBECCA
Other - Last Name:MESSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:955 BEN FRANKLIN HWY W
Mailing Address - Street 2:STE 7
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1049
Mailing Address - Country:US
Mailing Address - Phone:610-953-3232
Mailing Address - Fax:610-953-3230
Practice Address - Street 1:955 BEN FRANKLIN HWY W
Practice Address - Street 2:SUITE 7
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1048
Practice Address - Country:US
Practice Address - Phone:610-953-3232
Practice Address - Fax:610-953-3230
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1477831030OtherGROUP NPI
PA1930824OtherHIGHMARK
PA119179T9DMedicare PIN