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Individual

MARK STEPHEN HEINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2479 E COLORADO BLVD, SPEARFISH, SD 57783-3204
(605) 644-4460
(605) 644-4461
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0450
SD

Other

Enumeration date
05/31/2006
Last updated
02/05/2013
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