Provider Demographics
NPI:1053514026
Name:HEUER, MARCY R (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:R
Last Name:HEUER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17814 W ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53146
Mailing Address - Country:US
Mailing Address - Phone:262-366-7059
Mailing Address - Fax:
Practice Address - Street 1:19525 W NORTH AVENUE
Practice Address - Street 2:FRANCISCAN WOODS
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045
Practice Address - Country:US
Practice Address - Phone:262-785-1114
Practice Address - Fax:262-780-3805
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4574024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist