Provider Demographics
NPI:1164499695
Name:HEIMLICH, ALAN ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ANDREW
Last Name:HEIMLICH
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 1:2520 CALIFORNIA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201
Mailing Address - Country:US
Mailing Address - Phone:812-376-6084
Mailing Address - Fax:812-376-6569
Practice Address - Street 1:2520 CALIFORNIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201
Practice Address - Country:US
Practice Address - Phone:812-376-6084
Practice Address - Fax:812-376-6569
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001928A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81921Medicare UPIN
165660Medicare ID - Type Unspecified