Provider Demographics
NPI:1801176102
Name:HESKETT, MARGO LYNN (LMT)
Entity type:Individual
Prefix:MS
First Name:MARGO
Middle Name:LYNN
Last Name:HESKETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 DAVID SQ
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1611
Mailing Address - Country:US
Mailing Address - Phone:614-563-0924
Mailing Address - Fax:
Practice Address - Street 1:1145 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3117
Practice Address - Country:US
Practice Address - Phone:614-293-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33-013897172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist