Doctor Name: | MICAH L HEERINGA |
NPI Number: | 1033137757 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | PT00009405 |
Business Practice Address: | 1405 E Edison Ave Sunnyside, WA - 989441622 |
Business Phone Number: | 5098377400 |
Business Fax Number: | 5098375068 |
Mailing Address: | Po Box 307, BOUNTIFUL |
State: | UT |
Postal Code: | 840110307 |
Phone Number: | 8887006907 |
Fax Number: | 8012946917 |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00009405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |