Provider Demographics
NPI:1376894014
Name:HEARTLAND CENTER OF NATURAL HEALING
Entity Type:Organization
Organization Name:HEARTLAND CENTER OF NATURAL HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MONTZKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-237-3771
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-0007
Mailing Address - Country:US
Mailing Address - Phone:218-237-3771
Mailing Address - Fax:218-237-2311
Practice Address - Street 1:1202 1ST ST E
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-1849
Practice Address - Country:US
Practice Address - Phone:218-237-3771
Practice Address - Fax:218-237-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU53964Medicare UPIN