Basic Information
| Provider Information | |||||||||
| NPI: | 1689703035 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HEIT | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | JEANETTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15349 KNOX ST | ||||||||
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| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662219688 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 10300 W 103RD ST | ||||||||
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| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662142642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138941910 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11-01174 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 2002008823 | MO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.