Provider Demographics
NPI:1508021734
Name:IRELAND, HEATHER (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:IRELAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 HINCKLEY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1503
Mailing Address - Country:US
Mailing Address - Phone:650-652-3420
Mailing Address - Fax:
Practice Address - Street 1:888 HINCKLEY RD
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1503
Practice Address - Country:US
Practice Address - Phone:650-652-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-25714111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician