Individual ProviderLandon HeeresCase Manager/Care CoordinatorOther Service ProvidersPractice Address6715 Dorr St., Toledo, OH 43615(419) 868-1178PECOS EnrollmentBased on the most recent information from CMS, provider Landon Heeres does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1497399158Provider TypeIndividualFull NameHeeres, LandonGenderMaleSole ProprietorNoEnumeration Date11/5/2019Last Updated11/16/2020Contact InformationPractice LocationPractice Address6715 Dorr St., Toledo, OH 43615Phone(419) 868-1178Fax(419) 868-1989Mailing LocationMailing AddressPO Box 400, Holland, OH 43528PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode2251S0007XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID0385791DescriptionMedicaidIssuerUnlistedOhio