Individual
DR. STACI ANNETTE HEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3146 GOODMAN RD E, SOUTHAVEN, MS 38672-6429
(901) 626-5702
Mailing address
3146 GOODMAN RD E, SOUTHAVEN, MS 38672-6429
(901) 626-5702
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5825
MS
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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