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1063477131
KENNETH B HEITHOFF
ST LOUIS PARK, MN
NPI
1063477131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: MN 18169)
Enumeration Date
2006-04-20
Last Update Date
2007-07-08
Business Address
-- KENNETH B HEITHOFF MD
5775 WAYZATA BOULEVARD SUITE 190
ST LOUIS PARK, MN 55416
Phone number: 952-541-1840
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Mailing Address
-- KENNETH B HEITHOFF MD
PO BOX 1414 NCB-6
MINNEAPOLIS, MN 55480-1414
Phone number: 952-542-8553
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