Individual
HEATHER LYNNE EISENHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 992-6398
Mailing address
15650 STATE ROUTE 119 E, ANNA, OH 45302-9705
(619) 992-6398
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
12/06/2011
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