MRS. Holly Marie Heidemann, TOXICOLOGYFACILITATO

NPI #1750040432 in Pocatello, Idaho

Provider Information

NPI Number
1750040432
Entity Type
Individual
Name
MRS. Holly Marie Heidemann, TOXICOLOGYFACILITATO
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Clinical Medical Laboratory
Credential
TOXICOLOGYFACILITATO
Enumeration Date
Dec 10, 2021
Last Updated
Dec 10, 2021

Practice Location

Address
350 YELLOWSTONE AVE
State
Idaho
ZIP Code
83201
Phone
(208) 233-0940

Specialties & Taxonomy Codes

Specialty
Clinical Medical Laboratory

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Provider Name
Idaho State University

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