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General NPI Number Information
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NPI Number | 1205571213
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Entity Type | Individual
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Provider Name | HEATHER LYNNETTE OLIVER RTR
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Gender | Female
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 2521 278TH ST
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City | NEW LONDON
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State | IA
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Zip | 52645-9199
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Country | US
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Telephone | 319-931-7529
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 278TH ST
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City | NEW LONDON
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State | IA
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Zip | 52645-9199
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Country | US
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Telephone | 319-931-7529
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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 | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | 100686
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License Number State | IA
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