Individual
KATIE NEWCOMB-HEFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4051 OGLETOWN RD, STE 104, NEWARK, DE 19713-3101
(302) 894-1600
(302) 894-1601
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
25909
MD
225100000X
Physical Therapist
Primary
—
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11797345
CAQH
—
05
—
1891997086
—
DE
01
—
2873772000
AMERIHEALTH/IBC
—
01
—
50700092
NCA
—
01
—
888760504
NCA
—
Enumeration date
06/01/2007
Last updated
05/09/2017
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