Individual
HEIDI LEIGH HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 331-9119
Mailing address
6125 E GATEWAY CT, BOISE, ID 83716-9097
(208) 331-9119
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
03680908
ID
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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