Individual
JONATHAN HEYDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3030 WATERVIEW PKWY, RICHARDSON, TX 75080-1400
(972) 669-7070
Mailing address
1612 WESTRIDGE DR, PLANO, TX 75075-8737
(214) 552-8690
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5871
TX
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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