Individual
AYDAN LUKE HEAVNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4350 US 421 S, LILLINGTON, NC 27546-6760
(910) 893-1210
Mailing address
924 CLEAR CREEK CIR, LINCOLNTON, NC 28092-8005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001004740
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2023
Last updated
01/17/2024
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