Provider Demographics
NPI:1568555142
Name:HEYWOOD, GREGORY B (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:B
Last Name:HEYWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9700 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95837-1005
Mailing Address - Country:US
Mailing Address - Phone:916-921-2806
Mailing Address - Fax:916-927-2164
Practice Address - Street 1:225 30TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3359
Practice Address - Country:US
Practice Address - Phone:916-444-8390
Practice Address - Fax:916-444-1938
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA11204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor