Individual
MARK A HEINOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433, MADISON, WI 53792-0001
(608) 662-0817
Mailing address
2806 WARNER ST, MADISON, WI 53713-2161
(219) 508-0143
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15117
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15117
PHARMACIST
WI
Enumeration date
02/21/2008
Last updated
03/03/2008
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