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Individual

MRS. HEIDI SULICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3 OLD BRIDGE DR, POOLER, GA 31322-4906
(912) 450-6203
Mailing address
3 OLD BRIDGE DR, POOLER, GA 31322-4906
(912) 450-6203

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1450
VA
225200000X
Physical Therapy Assistant
1914
LA
225200000X
Physical Therapy Assistant
1917
SC
225200000X
Physical Therapy Assistant
2033959
TX
225200000X
Physical Therapy Assistant
Primary
2261
GA
225200000X
Physical Therapy Assistant
2291
NC
225200000X
Physical Therapy Assistant
23361
FL
225200000X
Physical Therapy Assistant
H2036
MD

Other

Enumeration date
07/19/2012
Last updated
07/19/2012
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