Individual
HEATHER J DUKES ROSALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 355-2300
(812) 355-2302
Mailing address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 355-2300
(812) 355-2302
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
02003675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200982130
—
IN
Enumeration date
08/04/2008
Last updated
12/04/2020
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