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Individual

HEATHER ISOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7101 HOFF ST, BLDG 9240, FT. BENNING, GA 31905
(706) 544-1148
Mailing address
3921 ASHMORE DR, COLUMBUS, GA 31909-3809
(706) 570-3797

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH012267
GA
163W00000X
Registered Nurse
RN284749
GA

Other

Enumeration date
06/07/2016
Last updated
07/28/2021
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