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Individual

DANIELLE REBECCA HEIDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC, SCAT

Contact information

Practice address
105 ASHLAND AVE, CLINTON, SC 29325-2960
(864) 541-4690
Mailing address
403 ELIZABETH ST, CLINTON, SC 29325-1917
(404) 664-6590

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2680
SC

Other

Enumeration date
11/15/2019
Last updated
11/15/2019
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