Provider Demographics
NPI:1447212071
Name:HEILMAN, JEFFREY BRUCE (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BRUCE
Last Name:HEILMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 SANDHILL RD, NUMBER ONE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046
Mailing Address - Country:US
Mailing Address - Phone:717-399-3000
Mailing Address - Fax:
Practice Address - Street 1:820 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1986
Practice Address - Country:US
Practice Address - Phone:717-399-3000
Practice Address - Fax:717-509-6393
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003798L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
177194Medicare UPIN