Provider Demographics
NPI:1760454748
Name:HEFFRON, DANIEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:HEFFRON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:HEFFRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 557
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:IA
Mailing Address - Zip Code:50144-0557
Mailing Address - Country:US
Mailing Address - Phone:641-446-3131
Mailing Address - Fax:641-446-3130
Practice Address - Street 1:311 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:IA
Practice Address - Zip Code:50144-1451
Practice Address - Country:US
Practice Address - Phone:641-446-3131
Practice Address - Fax:641-446-3130
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2146183Medicaid
IA33370OtherBCBS INS
IA33370OtherBCBS INS
IA2146183Medicaid