Individual
HEATHER LORIN BROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2331 SEMINOLE LN STE 103, CHARLOTTESVILLE, VA 22901
(432) 428-4789
(434) 529-6985
Mailing address
3455 HIGHWAY 81 SOUTH, LOGANVLLE, GA 30052-3918
(770) 554-0665
(770) 554-0685
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211770
VA
225100000X
Physical Therapist
291242
CA
2251X0800X
Orthopedic Physical Therapist
291242
CA
Other
Enumeration date
03/23/2016
Last updated
12/28/2018
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