Blake Heinonen

NPI #1235672437 in Conneaut, Ohio

Provider Information

NPI Number: 1235672437
Entity Type: Individual
Name: Blake Heinonen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Nov 21, 2016
Last Updated: Nov 21, 2016

Practice Location

Address: 903 LINCOLN DR
City: Conneaut
State: Ohio
ZIP Code: 44030-2137
Phone: (440) 813-7665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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