Provider Demographics
NPI:1932243664
Name:HEINS, SCOTT DAVID (MS PT CSCS)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
Last Name:HEINS
Suffix:
Gender:M
Credentials:MS PT CSCS
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Mailing Address - Street 1:18520 ELM TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4964
Mailing Address - Country:US
Mailing Address - Phone:414-559-3330
Mailing Address - Fax:
Practice Address - Street 1:16985 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5909
Practice Address - Country:US
Practice Address - Phone:262-821-4460
Practice Address - Fax:262-821-4464
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2019-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI6237024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist