Individual
MICHAEL A HETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
612 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 663-3150
(541) 975-5111
Mailing address
612 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 663-3150
(541) 975-5111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD13074
OR
Other
Enumeration date
07/06/2006
Last updated
12/18/2007
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