Individual
DR. BRIAN JAMES HEINTZELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD;RPH
Contact information
Practice address
777 RURAL AVE, SL2 EAST, WILLIAMSPORT, PA 17701-3109
(570) 321-2818
(570) 321-2819
Mailing address
91 BRENTWOOD CIR, BLOOMSBURG, PA 17815-7739
(570) 898-0993
(570) 321-2819
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP441016
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPI000520
PA AUTHORIZATION TO ADMINISTER INJECTABLES
PA
Enumeration date
08/29/2008
Last updated
08/29/2008
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