Individual
DIANE KAY HEIDEGGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 S RAILROAD AVE, DUNN, NC 28334-4853
(832) 257-4154
Mailing address
484 LENNOX DR, FAYETTEVILLE, NC 28303-5134
(832) 257-4154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1075919
TX
225100000X
Physical Therapist
Primary
CP018927T
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP018927T
PHYSICAL THERAPY LICENSE
NC
Enumeration date
04/10/2007
Last updated
12/04/2024
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