| Doctor Name: | KEITH RONALD HEINZELMAN |
| NPI Number: | 1194826479 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT00008747 |
| Business Practice Address: | 200 Winslow Way W Unit 200 Bainbridge Island, WA - 981104930 |
| Business Phone Number: | 2068558455 |
| Business Fax Number: | 2068558465 |
| Mailing Address: | 200 Winslow Way W Unit 200, BAINBRIDGE ISLAND |
| State: | WA |
| Postal Code: | 981104930 |
| Phone Number: | 2068558455 |
| Fax Number: | 2068558465 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 08/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00008747 |
| 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 |