Provider Demographics
NPI:1447580311
Name:HEFFRON CHIROPRACTIC CLINIC PLC
Entity Type:Organization
Organization Name:HEFFRON CHIROPRACTIC CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-437-1927
Mailing Address - Street 1:116 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-1708
Mailing Address - Country:US
Mailing Address - Phone:641-437-4278
Mailing Address - Fax:641-856-5747
Practice Address - Street 1:116 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1708
Practice Address - Country:US
Practice Address - Phone:641-437-4278
Practice Address - Fax:641-856-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA350035220OtherRR MEDICARE
IA0213025Medicaid
IA21302OtherBCBS
IA21302OtherBCBS
IA0213025Medicaid