Provider Demographics
NPI:1477517266
Name:HEIMLICH, CHRISTOPHER OWEN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:OWEN
Last Name:HEIMLICH
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 1:6501 E GREENWAY PKWY
Mailing Address - Street 2:#157
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2065
Mailing Address - Country:US
Mailing Address - Phone:480-991-9355
Mailing Address - Fax:480-998-2663
Practice Address - Street 1:6501 E GREENWAY PKWY
Practice Address - Street 2:#157
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2065
Practice Address - Country:US
Practice Address - Phone:480-991-9355
Practice Address - Fax:480-998-2663
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC5449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1030449OtherAETNA PROVIDER #
AZ444935OtherAHCCS
AZAZ0245290OtherBC/BS
AZZ84484Medicare PIN