Individual
MRS. LORI A HEINRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10303 N PORT WASHINGTON RD, SUITE 101, MEQUON, WI 53092-5760
(262) 240-0440
(262) 240-0441
Mailing address
10303 N PORT WASHINGTON RD, SUITE 101, MEQUON, WI 53092-5760
(262) 240-0440
(262) 240-0441
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
29744-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31824000
—
WI
Enumeration date
10/04/2006
Last updated
07/19/2007
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