Provider Demographics
NPI:1639536329
Name:HEATH, GENEVIEVE RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:RAE
Last Name:HEATH
Suffix:
Gender:F
Credentials:DC
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Other - Credentials:
Mailing Address - Street 1:GULF COAST INJURY CENTER
Mailing Address - Street 2:322 S FALKENBURG RD
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619
Mailing Address - Country:US
Mailing Address - Phone:813-626-2311
Mailing Address - Fax:813-434-4233
Practice Address - Street 1:GULF COAST INJURY CENTER
Practice Address - Street 2:322 S. FALKENBURG RD
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619
Practice Address - Country:US
Practice Address - Phone:315-539-3262
Practice Address - Fax:315-539-5221
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH13571111N00000X
NYX012791-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor