Provider Demographics
NPI:1871701185
Name:EIGSTI, HEIDI JOHNSON (DPT,PCS)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:JOHNSON
Last Name:EIGSTI
Suffix:
Gender:F
Credentials:DPT,PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14063 W CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-5301
Mailing Address - Country:US
Mailing Address - Phone:303-458-4910
Mailing Address - Fax:303-964-5474
Practice Address - Street 1:29023 UPPER BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7704
Practice Address - Country:US
Practice Address - Phone:303-670-1170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist