Provider Demographics
NPI:1871810408
Name:MCLAIN, HEATHER ANN (DPT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:MAILKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17101 SNOWMOBILE LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7043
Mailing Address - Country:US
Mailing Address - Phone:907-694-8085
Mailing Address - Fax:907-694-8526
Practice Address - Street 1:17101 SNOWMOBILE LN
Practice Address - Street 2:SUITE 202
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7043
Practice Address - Country:US
Practice Address - Phone:907-694-8085
Practice Address - Fax:907-694-8526
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist