Organization
GEORGIA HEISSER
Active
Organization
GEORGIA HEISSER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GEORGIA HEISSER LMT (MASSAGE THERAPIST)
(832) 849-8298
Entity
Organization
Contact information
Practice address
7750 PARK NORTH DR, BEAUMONT, TX 77708-2425
(832) 849-8298
Mailing address
PO BOX 21285, BEAUMONT, TX 77720-1285
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
MT126192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
RESPIRATORY, DEVELOPMENTAL, REHAB & RESTORATIVE SERVICE PROVIDERS
TX
Enumeration date
01/24/2017
Last updated
01/24/2017
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