Individual
MISS HEIDI RAQUEL CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29903 SUNNY BEACH RD, GRAND RAPIDS, MN 55744-4528
(218) 326-1485
Mailing address
29903 SUNNY BEACH RD, GRAND RAPIDS, MN 55744-4528
(218) 326-1485
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
07/04/2007
Last updated
07/08/2007
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