Provider Demographics
NPI:1053572602
Name:HECKMAN, GRACE (MS, ATC, LAT, CSCS)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:MS, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1535
Mailing Address - Country:US
Mailing Address - Phone:484-794-5680
Mailing Address - Fax:
Practice Address - Street 1:4897 N TWIN VALLEY RD
Practice Address - Street 2:
Practice Address - City:ELVERSON
Practice Address - State:PA
Practice Address - Zip Code:19520-9340
Practice Address - Country:US
Practice Address - Phone:610-286-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001767A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer