Individual
HEATHER LEIGH RAYNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
690 MEDICAL PARK DR, AIKEN, SC 29801-6348
(803) 648-8344
Mailing address
4029 SWEETBRIAR DR, MARTINEZ, GA 30907-4310
(706) 650-8040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2361
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1039
—
SC
Enumeration date
12/26/2006
Last updated
07/08/2007
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