Provider Demographics
NPI:1033320387
Name:HELLER, DEBRA G (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:G
Last Name:HELLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:MILLHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:16854-0305
Mailing Address - Country:US
Mailing Address - Phone:814-349-8849
Mailing Address - Fax:
Practice Address - Street 1:122 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILLHEIM
Practice Address - State:PA
Practice Address - Zip Code:16854-0305
Practice Address - Country:US
Practice Address - Phone:814-349-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006031L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
02923400OtherBCBS GROUP NUMBER
HE848608OtherBCBS PROVIDER NUMBER