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1740619840
MICHAEL HEISE
MATTOON, IL
NPI
1740619840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085004872)
Enumeration Date
2013-11-08
Last Update Date
2018-09-24
Business Address
MICHAEL HEISE PA
1005 HEALTH CENTER DR STE 103
MATTOON, IL 61938-4693
Phone number: 217-258-4051
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Mailing Address
MICHAEL HEISE PA
1005 HEALTH CENTER DR STE 201
MATTOON, IL 61938-4693
Phone number: 217-238-6055
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