Individual
DR. JOSEPH ALAN HEITZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 S CENTER AVE, MERRILL, WI 54452-3404
(715) 536-8671
Mailing address
2814 RUSCO DR, WEST BEND, WI 53095-9780
(262) 338-6176
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26317020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31380400
—
WI
Enumeration date
09/07/2005
Last updated
07/08/2007
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