Provider Demographics
NPI:1184841017
Name:HEARTLAND CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:HEARTLAND CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-285-5641
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62363-0475
Mailing Address - Country:US
Mailing Address - Phone:217-285-5641
Mailing Address - Fax:217-285-1844
Practice Address - Street 1:813 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363-1353
Practice Address - Country:US
Practice Address - Phone:217-285-5641
Practice Address - Fax:217-285-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty