Individual
JOE HEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 392-3359
Mailing address
5876 E SILAXO RD, CLOVIS, CA 93619-9542
(559) 392-3359
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
417994
CA
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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