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Individual

HEATHER KAY VANDERWEIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
6363 FRANCE AVE S, #100, EDINA, MN 55435-2129
(952) 920-8525
Mailing address
4414 CHESTNUT LN NE, PRIOR LAKE, MN 55372-1186

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6904
MN

Other

Enumeration date
08/10/2006
Last updated
07/08/2007
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