Individual
SHELBY ANN HEATWOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1209 HARRISON AVE., GOODLAND, KS 67735
(785) 890-1539
Mailing address
1209 HARRISON STREET, GOODLAND, KS 67735
Taxonomy
Speciality
Code
Description
License number
State
246ZX2200X
Orthopedic Assistant
Primary
24-01126
KS
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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