| Organization Name: | HEARTLAND THERAPY PROVIDER NETWORK |
| NPI Number: | 1649312539 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY INGRAM-MITCHELL (EXECUTIVE DIRECTOR) |
| Mailing Address: | 524 Kingsley Ave Orange Park |
| State: | FL US |
| Postal Code: | 320734830 |
| Phone Number: | 9042157200 |
| Fax Number: | 9045410616 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| 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 |