Individual
JENNIFER HEISEL-MANGANO
Active
Individual
JENNIFER HEISEL-MANGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT05017
OH
2251S0007X
Sports Physical Therapist
PT05017
OH
2251X0800X
Orthopedic Physical Therapist
PT05017
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT05017
OT PT ATC BOARD
OH
Enumeration date
10/26/2005
Last updated
03/10/2011
Update your record
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