Individual
HEIDI SUSAN HOLDERIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
176 US OVAL STE 3, PLATTSBURGH, NY 12903-3914
(518) 310-0900
Mailing address
40 LONESOME POND RD, SARANAC LAKE, NY 12983-8321
(518) 891-4293
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
039170
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039170
PHYSICAL THERAPY LICENSE
NY
Enumeration date
02/05/2020
Last updated
02/05/2020
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