Individual
MR. MICHAEL JOSEPH HETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
10437 ILLINOIS RD, FORT WAYNE, IN 46814-9181
(260) 426-4138
Mailing address
10437 ILLINOIS RD, FORT WAYNE, IN 46814-9181
(260) 426-4138
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
17001328A
IN
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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