Individual
MATISON HEITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
745 LOGAN ST SE, GRAND RAPIDS, MI 49503-5559
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704375771
MI
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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