Individual
HEIDI SUSANNA EHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
457 N MAIN ST, LA GRANGE, TX 78945-1937
(979) 968-5865
Mailing address
1017 KONETZKE LN, LA GRANGE, TX 78945-4384
(979) 220-7751
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2139127
TX
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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