| Doctor Name: | MRS. HEATHER RENEE COSTAS |
| NPI Number: | 1104915644 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSPT, CIMT |
| License Number: | 5501011833 |
| Business Practice Address: | 50505 Schoenherr Rd Ste 210 P Shelby Twp, MI - 483153140 |
| Business Phone Number: | 5868846689 |
| Business Fax Number: | 5868846678 |
| Mailing Address: | 33900 Harper Ave, Suite 104 CLINTON TOWNSHIP |
| State: | MI |
| Postal Code: | 480354258 |
| Phone Number: | 5864169100 |
| Fax Number: | 5284169103 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 11/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501011833 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| 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 |