Individual
HEIDI LEIGH PANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1000 SOUTH COLUMBIA ROAD, GRAND FORKS, ND 58206-6002
(701) 780-5000
(808) 674-9696
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
(808) 674-9696
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1338
ND
225100000X
Physical Therapist
2281
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000242578
HMSA 65C/C
HI
05
—
53799601
—
HI
Enumeration date
06/10/2006
Last updated
07/21/2022
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