Provider Demographics
NPI:1073591251
Name:TREHARNE, DAVID HEATH (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HEATH
Last Name:TREHARNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-5443
Mailing Address - Country:US
Mailing Address - Phone:563-391-1679
Mailing Address - Fax:309-786-7940
Practice Address - Street 1:1804 3RD AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8020
Practice Address - Country:US
Practice Address - Phone:309-786-8733
Practice Address - Fax:309-786-7940
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor