Lane O. Heder PA-C, MPAS

NPI 1083641286 - Physician Assistant - 363AM0700X

NPI Details
NPI 1083641286
Gender Male
Enumeration Date 06/26/2006
Last Updated 09/17/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
3225 W GORDON AVE
SUITE 1
LAYTON UT, 84041-6508, US
Phone (801) 397-6150
Fax (901) 391-6151
Business Location
4650 HARRISON BLVD
OGDEN UT, 84403-4303, US
Phone (801) 475-3000
Fax (801) 773-9577
Toxanomy
Taxonomy Code 363AM0700X
License State Utah
License Number 378677-1206
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According to our database, Lane O. Heder PA-C, MPAS NPI is 1083641286, taxonomy code is 363AM0700X and license number is 378677-1206, license state is located at Utah. Lane O. Heder PA-C, MPAS physically located at 3225 W Gordon Ave, Layton UT, 84041-6508. NPI Number Lane O. Heder PA-C, MPAS has the Individual type.

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1083641286 NPI number is provided on an as is basis without warranty of any kind. 1083641286 is maintained by the National Plan & Provider Enumeration System. The contents of Lane O. Heder PA-C, MPAS are for informational purposes only.