Individual
HEATHER ROBERTSON
Active
Individual
HEATHER ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1183
NM
2251G0304X
Geriatric Physical Therapist
1183
NM
2251X0800X
Orthopedic Physical Therapist
1183
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610375300
OWCP PROVIDER NUMBER
NM
01
—
NM00Q545
BLUE CROSS BLUE SHIELD
NM
Enumeration date
10/03/2006
Last updated
04/10/2012
Update your record
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