Individual
HEATHER BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2 LEE AVE UNIT 103, GEORGETOWN, DE 19947-2149
(302) 500-6363
Mailing address
7970 RAVEN RD, LAKE TOMAHAWK, WI 54539-9588
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14827-24
WI
225100000X
Physical Therapist
Primary
J1-0004186
DE
225100000X
Physical Therapist
PTL.0016499
CO
Other
Enumeration date
01/27/2020
Last updated
07/23/2020
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