Individual
DR. DANIEL PAUL HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
919 2ND ST NE, CANTON, OH 44704-1132
(330) 453-3386
Mailing address
919 2ND ST NE, CANTON, OH 44704-1132
(330) 453-3386
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
010769
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077444
—
OH
Enumeration date
10/15/2009
Last updated
05/17/2016
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