Provider Demographics
NPI:1982988960
Name:HEITKER, MEGAN KATHLEEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:HEITKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:KATHLEEN
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10400 READING ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-4816
Mailing Address - Country:US
Mailing Address - Phone:513-733-3370
Mailing Address - Fax:513-786-7893
Practice Address - Street 1:10400 READING ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4816
Practice Address - Country:US
Practice Address - Phone:513-733-3370
Practice Address - Fax:513-786-7893
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist