Individual
KRISTINE HEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1755 WITTINGTON PL STE 175, DALLAS, TX 75234-1905
(214) 442-4115
Mailing address
511 EASTVIEW TERRACE, APT. 2, ABINGDON, MD 21009
(732) 608-4506
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4683
MD
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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