Individual
MRS. MARGE HEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.C.P.
Contact information
Practice address
2753 E BROADWAY RD, SUITE 101-454, MESA, AZ 85204-1579
(480) 659-6964
(480) 659-6791
Mailing address
PO BOX 27588, TEMPE, AZ 85285-7588
(480) 777-0607
(480) 777-1345
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004052
—
AZ
Enumeration date
07/08/2006
Last updated
08/18/2009
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