Individual
MRS. HEATHER ARLENE ROEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
409 NW 9TH AVE, ALEDO, IL 61231-1258
(309) 582-5301
(309) 582-3797
Mailing address
409 NW 9TH AVE, MERCER COUNTY HOSPITAL, ALEDO, IL 61231-1258
(309) 582-5301
(309) 582-3797
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.015946
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36007544401
—
IL
05
—
366007544001
—
IL
Enumeration date
10/23/2012
Last updated
10/23/2012
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