Basic Information
| Provider Information | |||||||||
| NPI: | 1295875979 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NITSCH | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT, OCS, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 676 HUNTING FIELDS RD | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212202325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104586753 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 FRONT AVE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210935300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108234263 | ||||||||
| FaxNumber: | 4108231861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 06/22/2009 | ||||||||
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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 | 2251H1200X | 20000 | MD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | 225100000X | 20000 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.