Basic Information
| Provider Information | |||||||||
| NPI: | 1801046537 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HEISER | ||||||||
| FirstName: | SARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13688 OAKLEY LN | ||||||||
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| City: | SAINT FRANCISVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707759508 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4739 HIGHWAY 10 | ||||||||
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| City: | JACKSON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707483509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012504815 | ||||||||
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| ProviderEnumerationDate: | 09/30/2008 | ||||||||
| LastUpdateDate: | 09/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05267R | LA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.