Basic Information
| Provider Information | |||||||||
| NPI: | 1205891926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRACCO | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 732 VANCE DR | ||||||||
| Address2: | |||||||||
| City: | GLENSIDE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190381320 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 319 W COUNTY LINE RD | ||||||||
| Address2: | |||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190401605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159576060 | ||||||||
| FaxNumber: | 2152939902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 09/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT017441 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.