Provider Demographics
NPI:1710050349
Name:CAMP, HEATHER ROBINSON (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ROBINSON
Last Name:CAMP
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 1:2080 FAIRBURN RD STE F
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1064
Mailing Address - Country:US
Mailing Address - Phone:770-920-1707
Mailing Address - Fax:770-920-1707
Practice Address - Street 1:2080 FAIRBURN RD STE F
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1064
Practice Address - Country:US
Practice Address - Phone:770-920-1707
Practice Address - Fax:770-920-1707
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHGWMedicare ID - Type Unspecified