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Individual

HEIDI ANN BROCKMYRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.AC.

Contact information

Practice address
4870 SANTA MONICA AVE, SUITE 2C, SAN DIEGO, CA 92107-4802
(619) 518-6608
Mailing address
4870 SANTA MONICA AVE, SUITE 2C, SAN DIEGO, CA 92107-4802
(619) 518-6608

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
12558
CA

Other

Enumeration date
09/17/2008
Last updated
09/17/2008
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