Individual
JORDAN DEAN HEINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2805 5TH ST, RAPID CITY, SD 57701-6003
(605) 755-5700
Mailing address
1260 ZIEBACH ST, RAPID CITY, SD 57703-0172
(620) 344-1538
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1116
SD
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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