Provider Demographics
NPI:1164879383
Name:LAKINS, HEATHER (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:LAKINS
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 1:1620 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-6424
Mailing Address - Country:US
Mailing Address - Phone:727-946-0566
Mailing Address - Fax:
Practice Address - Street 1:1620 HARVARD ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-6424
Practice Address - Country:US
Practice Address - Phone:727-946-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor