Basic Information
| Provider Information | |||||||||
| NPI: | 1316278294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HYNDMAN | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 W PARK ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA CITY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467251611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2602290823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 N WABASH RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MARION | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469521300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656513229 | ||||||||
| FaxNumber: | 7656513227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2010 | ||||||||
| LastUpdateDate: | 01/16/2010 | ||||||||
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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 | 225X00000X | 31003399A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.