Provider Demographics
NPI:1356643423
Name:PICKERING, HEIDI JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:JANE
Last Name:PICKERING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:HEIDI
Other - Middle Name:JANE
Other - Last Name:PATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:19011 N DALE MABRY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548
Mailing Address - Country:US
Mailing Address - Phone:813-948-1781
Mailing Address - Fax:813-406-4434
Practice Address - Street 1:19011 N DALE MABRY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548
Practice Address - Country:US
Practice Address - Phone:813-948-1781
Practice Address - Fax:813-406-4434
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor