Provider Demographics
NPI:1619159266
Name:WALKER, HEATHER ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:WALKER
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 1:1580 KING AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2058
Mailing Address - Country:US
Mailing Address - Phone:614-488-6820
Mailing Address - Fax:614-488-6830
Practice Address - Street 1:1580 KING AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2058
Practice Address - Country:US
Practice Address - Phone:614-488-6820
Practice Address - Fax:614-488-6830
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHWA4125042Medicare PIN