Doctor Name: | KYLE R HEISE |
NPI Number: | 1629214036 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | PT60045957 |
Business Practice Address: | 17800 Talbot Rd S Suite D Renton, WA - 980555740 |
Business Phone Number: | 4252779096 |
Business Fax Number: | 4252771206 |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | 6302962223 |
Fax Number: | 4254514390 |
NPI Enumeration Date: | 01/06/2009 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT60045957 |
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 |