Individual
HEIDI LYNN PERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
840 CORDOBA DR, CONWAY, AR 72034-7594
(501) 499-0901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3286
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185787721
—
AR
01
—
P01060658
MEDICARE RAILROAD
AR
Enumeration date
11/07/2010
Last updated
09/11/2012
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