Provider Demographics
NPI:1386042265
Name:HECK, TERESA (DC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:D
Other - Last Name:HECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:202 SHIRE LN
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-9474
Mailing Address - Country:US
Mailing Address - Phone:610-621-6066
Mailing Address - Fax:
Practice Address - Street 1:202 SHIRE LN
Practice Address - Street 2:
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-9474
Practice Address - Country:US
Practice Address - Phone:610-621-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005219L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2705271OtherEIN