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Individual

DR. GRACE M HEITSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
88455 PIKE ROAD, HIGHWAY 13, BAYFIELD, WI 54814
(715) 779-3707
(715) 779-3711
Mailing address
PO BOX 529, BAYFIELD, WI 54814-0529
(715) 779-3707
(715) 779-3711

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30572-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31585500
WI
05
355214400
MN
Enumeration date
07/24/2006
Last updated
07/08/2007
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