Individual
DR. THOMAS HEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP489143
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017373530002
PA STATE MEDICAL ASSISTAN
PA
Enumeration date
01/25/2006
Last updated
11/17/2011
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