Individual
HEIDI JEAN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12100 W DEARBOURN AVE, WAUWATOSA, WI 53226-3840
(414) 870-3548
Mailing address
726 S 111TH ST, MILWAUKEE, WI 53214-2331
(414) 456-9242
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11040-146
WI
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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