Individual
MR. JUSTIN MATTHEW HEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2145 LORD PROPRIETOR LN, WAXHAW, NC 28173-6925
(704) 900-4104
Mailing address
2145 LORD PROPRIETOR LN, WAXHAW, NC 28173-6925
(704) 900-4104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.6471
SC
225100000X
Physical Therapist
PT10543
NC
Other
Enumeration date
06/30/2011
Last updated
08/17/2011
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