Individual
GAYLENE HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT-SC
Contact information
Practice address
502 COPPER ST STE 5, HURLEY, WI 54534-1386
(715) 563-0092
Mailing address
14337N STATELINE RD, HURLEY, WI 54534
(715) 360-1250
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-2770
—
246ZX2200X
Orthopedic Assistant
16-1140
—
Other
Enumeration date
06/30/2017
Last updated
03/17/2018
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