Individual
DEREK B HEISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5393 ROOSEVELT BLVD STE 17, JACKSONVILLE, FL 32210-8424
(904) 389-8570
(904) 389-8599
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305209392
VA
225100000X
Physical Therapist
Primary
PT30517
FL
Other
Enumeration date
05/21/2015
Last updated
12/02/2020
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