Provider Demographics
NPI:1922200831
Name:BRANLUND, HEIDI MARLENE (LAC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARLENE
Last Name:BRANLUND
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 EUREKA WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0177
Mailing Address - Country:US
Mailing Address - Phone:530-241-9233
Mailing Address - Fax:
Practice Address - Street 1:3665 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0177
Practice Address - Country:US
Practice Address - Phone:530-241-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist