Provider Demographics
NPI:1003918921
Name:HECK, KRISTEN ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:HECK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:320 E FONTANERO ST
Mailing Address - Street 2:STE 201
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7525
Mailing Address - Country:US
Mailing Address - Phone:719-599-2020
Mailing Address - Fax:719-632-6088
Practice Address - Street 1:41301 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-8046
Practice Address - Country:US
Practice Address - Phone:256-245-4104
Practice Address - Fax:256-245-8668
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003515152W00000X
ALS-A82-TA-661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty