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General NPI Number Information
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NPI Number | 1194061697
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Entity Type | Individual
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Provider Name | CARA HEINRICH R.T.(R)(M)
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Gender | Female
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 01/12/2013
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Provider Practice Location Address
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Address Line | 5589 GREENWICH RD #175
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6565
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Country | US
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Telephone | 757-434-3970
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Fax |
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Provider Business Mailing Address
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Address Line | 523 LYNNFIELD RD
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City | CHESAPEAKE
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State | VA
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Zip | 23323-7005
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Country | US
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Telephone | 757-606-2444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 0120006199
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License Number State | VA
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