Heidi Clark, P.T.
Individual provider Active NPI Physical Therapist · Commerce TWP, MI
NPI 1962821041 · NPPES record last updated Apr 15, 2014
Key facts
- NPI
- 1962821041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501016656 (MI)
- Practice address
- 2455 Union Lake Rd
Commerce TWP, MI 48382-3596 - Phone
- (248) 363-1234
- Fax
- (248) 353-1211
- NPI assigned
- Apr 15, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501016656 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Auto & Work Comp Rehab LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016656 | MI | Yes |
Addresses
Primary practice location
2455 Union Lake Rd
Commerce TWP, MI 48382-3596
Mailing address
29255 Northwestern Hwy
Suite 300
Southfield, MI 48034-1018
Phone (248) 353-1234
Other providers in Commerce TWP, MI
- David Cantor
- Care With Compassion Physician Group PC
- Shannon Carlson
- Jung Hoon Chang
- Charter Township of Commerce
- Jamie Lynn Clark
- Cathy Clubb
- Colleen Bertani PC
- Endia Collins
- Commerce Internal Medicine, P.C.
All providers in Commerce TWP, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2014. 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.