Most Relevant Information
Provider Data
| NPI Number: | 1003402736 |
| Provider Name: | MARY M HEATER |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/16/2020 |
| Last Updated: | 12/16/2020 |
Provider Practice Location
2726 HOOD AVE
SHINNSTON
WV
264316976
Practice Location Phone/Fax
| Phone: | 3045921666 |
| Fax: |
Provider Mailing Location
2726 HOOD AVE
SHINNSTON
WV
264316976
Provider Mailing Phone/Fax
| Phone: | 3045921666 |
| Fax: |