Provider Demographics
NPI:1447296942
Name:HEITMANN, DEBRA KAY (PT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:HEITMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6608
Mailing Address - Country:US
Mailing Address - Phone:207-322-3135
Mailing Address - Fax:
Practice Address - Street 1:170 PLEASANT ST
Practice Address - Street 2:KNO-WAL-LIN HOMECARE
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2119
Practice Address - Country:US
Practice Address - Phone:207-594-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT5360225100000X
COPTL.0002990225100000X
CT12521225100000X
MEPT1615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist