Heather Michelle Tabata, DPT
Individual provider Active NPI Physical Therapist · Hyden, KY
NPI 1275968612 · NPPES record last updated Apr 19, 2016
Key facts
- NPI
- 1275968612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT006275 (KY)
- Practice address
- 130 Kate Ireland Dr
Hyden, KY 41749-9071 - Phone
- (606) 672-2901
- Fax
- (606) 672-1966
- NPI assigned
- Sep 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT006275 | KY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT006275 | KY | Yes |
Addresses
Primary practice location
130 Kate Ireland Dr
Hyden, KY 41749-9071
Mailing address
130 Kate Ireland Dr
Hyden, KY 41749-9071
Phone (606) 672-2901
Other providers in Hyden, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.