Individual
MELISSA M HEINOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 689-7044
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006260
IL
Other
Enumeration date
04/16/2019
Last updated
12/31/2019
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