Provider Demographics
NPI:1083944300
Name:HEID, TREVOR JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:JOHN
Last Name:HEID
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 1:16944 W BELL RD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8950
Mailing Address - Country:US
Mailing Address - Phone:623-505-7226
Mailing Address - Fax:623-518-2679
Practice Address - Street 1:16944 W BELL RD
Practice Address - Street 2:SUITE 602
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8950
Practice Address - Country:US
Practice Address - Phone:623-505-7226
Practice Address - Fax:623-518-2679
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor