Individual
MARTIN THOMAS HEIDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1920 E 13TH AVE, DENVER, CO 80206-2002
(303) 321-2482
Mailing address
8919 LARIAT LOOP, ELIZABETH, CO 80107-9317
(303) 646-3192
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/03/2007
Last updated
07/08/2007
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