| NPI | 1275634354 |
|---|---|
| Former Name | HEIDI MARIE MOENING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10527) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 645-039) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-03-06 |