Provider Demographics
NPI:1932361813
Name:FRITSCH, HEATHER A (LMT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:A
Last Name:FRITSCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 S HOLMEN DR
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9467
Mailing Address - Country:US
Mailing Address - Phone:608-526-9888
Mailing Address - Fax:608-526-9965
Practice Address - Street 1:106 S HOLMEN DR STE 2
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9468
Practice Address - Country:US
Practice Address - Phone:608-526-9888
Practice Address - Fax:608-526-9888
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1584-19225200000X
WI15556-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant