Kody John-Everett Heitz

NPI #1760838775 in Wayne, Michigan

Provider Information

NPI Number: 1760838775
Entity Type: Individual
Name: Kody John-Everett Heitz
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 9, 2016
Last Updated: May 9, 2016

Practice Location

Address: 35640 W MICHIGAN AVE
City: Wayne
State: Michigan
ZIP Code: 48184-1628
Phone: (419) 203-0578

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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