Individual
MRS. CRYSTAL MARIE HEILIGENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6320B W UNION HILLS DR, STE B2300, GLENDALE, AZ 85308-1376
(623) 561-9113
(623) 561-6148
Mailing address
2500 W UTOPIA RD, STE. 100, PHOENIX, AZ 85027-4171
(623) 434-6200
(623) 434-6164
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4296
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4296
LICENSE
AZ
Enumeration date
10/07/2008
Last updated
10/03/2013
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