| NPI | 1609100635 |
|---|---|
| Former Name | CHANDRA DENISE HEAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NC 11396) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2025-02-14 |