Individual
MARLA HERONEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5550 E KELLOGG DR, WICHITA, KS 67218
(316) 469-0688
Mailing address
407 ELM ST, LA CROSSE, KS 67548-9752
(316) 650-4877
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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