Provider Demographics
NPI:1972884948
Name:MCDERMOTT, HEIDI MICHELLE (DPT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MICHELLE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MICHELLE
Other - Last Name:KEEFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:2344 SCHILLINGER RD S STE 1B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4177
Practice Address - Country:US
Practice Address - Phone:251-301-9812
Practice Address - Fax:251-301-9813
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6953225100000X
AL6953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist