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Individual

DR. HEIDI JO YOUNG HETLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT, MS, PCS

Contact information

Practice address
1214 GOLDENVIEW CT, DURHAM, NC 27713-8207
(919) 698-2970
Mailing address
1214 GOLDENVIEW CT, DURHAM, NC 27713-8207
(919) 484-8144

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
5172
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
89776
BCBS OF NC
NC
Enumeration date
03/12/2007
Last updated
11/30/2011
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