Individual
GREGORY HEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., ATC, LAT
Contact information
Practice address
1325 SAN MARCO BLVD, SUITE 102, JACKSONVILLE, FL 32207-8568
(904) 858-7045
(904) 858-7047
Mailing address
1325 SAN MARCO BLVD, SUITE 102, JACKSONVILLE, FL 32207-8568
(904) 858-7045
(904) 858-7047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3938
FL
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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