Provider Demographics
NPI:1548875271
Name:HECKAMAN, ERICK JAMES (DPT)
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:JAMES
Last Name:HECKAMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26771 COUNTY ROAD 38
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-7447
Mailing Address - Country:US
Mailing Address - Phone:574-221-9213
Mailing Address - Fax:
Practice Address - Street 1:3000 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-8975
Practice Address - Country:US
Practice Address - Phone:574-773-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008074225100000X
MI225100000X
IN05014804A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist