Provider Demographics
NPI:1568242071
Name:HECKERT, DEAVEN FAYE (DC)
Entity Type:Individual
Prefix:
First Name:DEAVEN
Middle Name:FAYE
Last Name:HECKERT
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 1:21211 W 223RD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-3068
Mailing Address - Country:US
Mailing Address - Phone:913-294-3851
Mailing Address - Fax:
Practice Address - Street 1:21211 W 223RD ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-3068
Practice Address - Country:US
Practice Address - Phone:913-294-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor