PHILLIP NORMAN HEISTAD

WHITE LAKE, WI
NPI1134493067
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy237600000X Audiologist-Hearing Aid Fitter
(Licence: WI  237700000X)
Enumeration Date2012-02-23
Last Update Date2012-02-23
Business Address
-- PHILLIP NORMAN HEISTAD
1226 LAKE ST
WHITE LAKE, WI 54491-9750
Phone number: 715-882-8107
Mailing Address
-- PHILLIP NORMAN HEISTAD
1226 LAKE ST
WHITE LAKE, WI 54491-9750
Phone number: 715-882-8107