Doctor Name: | MR. DONALD GARY HEACOCK |
NPI Number: | 1023022324 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 15332 |
Business Practice Address: | 7310 Ritchie Hwy Suite 500 Glen Burnie, MD - 210613065 |
Business Phone Number: | 4107664435 |
Business Fax Number: | 4107664437 |
Mailing Address: | 7310 Ritchie Hwy, Suite 500 GLEN BURNIE |
State: | MD |
Postal Code: | 210613065 |
Phone Number: | 4107664435 |
Fax Number: | 4107664437 |
NPI Enumeration Date: | 07/29/2006 |
NPI Last Update Date: | 04/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 15332 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |