Individual
JOAN E HEIDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA-C
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 778-4852
Mailing address
9760 EPHESUS CHURCH RD, VILLA RICA, GA 30180-4139
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
002694
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000840A
—
GA
Enumeration date
11/28/2006
Last updated
10/23/2018
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