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Individual

MR. KEITH RONALD HEINZELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, CHT, MTC

Contact information

Practice address
563 MADISON AVE N, BAINBRIDGE ISLAND, WA 98110-1768
(206) 855-8455
(206) 855-8465
Mailing address
563 MADISON AVE N, BAINBRIDGE ISLAND, WA 98110-1768
(206) 855-8455
(206) 855-8465

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008747
WA
2251H1200X
Hand Physical Therapist
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8450744
WA
Enumeration date
09/26/2006
Last updated
12/28/2020
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