Provider Demographics
NPI:1336320019
Name:SKS INC
Entity Type:Organization
Organization Name:SKS INC
Other - Org Name:PATRICK S HEFFRON
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-872-2435
Mailing Address - Street 1:410 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-1530
Mailing Address - Country:US
Mailing Address - Phone:641-872-2435
Mailing Address - Fax:641-872-2438
Practice Address - Street 1:410 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1530
Practice Address - Country:US
Practice Address - Phone:641-872-2435
Practice Address - Fax:641-872-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0400529Medicaid
IA0400529Medicaid
IAI12845Medicare PIN