Provider Demographics
NPI:1407551963
Name:MANN, HEATHER KOREN (ARRT (CT) CRT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:KOREN
Last Name:MANN
Suffix:
Gender:F
Credentials:ARRT (CT) CRT
Other - Prefix:
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Mailing Address - Street 1:1676 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:COPPEROPOLIS
Mailing Address - State:CA
Mailing Address - Zip Code:95228-9529
Mailing Address - Country:US
Mailing Address - Phone:209-840-3992
Mailing Address - Fax:
Practice Address - Street 1:1676 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:COPPEROPOLIS
Practice Address - State:CA
Practice Address - Zip Code:95228-9529
Practice Address - Country:US
Practice Address - Phone:209-840-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist