Individual
ANDREA HEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
SANTO DOMINGO HEALTH CENTER, 85 HWY 22, SANTO DOMINGO, NM 87052
(505) 465-3060
(505) 465-1185
Mailing address
SANTO DOMINGO HEALTH CENTER, 85 HWY 22, SANTO DOMINGO, NM 87052
(505) 465-3060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
9110591
FL
Other
Enumeration date
01/03/2007
Last updated
03/17/2018
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