Individual
HOLLY A HEITZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LATC
Contact information
Practice address
8227 NORTHWEST BLVD, STE.160, INDIANAPOLIS, IN 46278-1387
(317) 415-5747
Mailing address
1030 E 81ST ST, INDIANAPOLIS, IN 46240-2680
(317) 370-0923
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000330A
IN
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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