Provider Demographics
NPI:1821304320
Name:H G HEEDER CHIROPRACTIC INC
Entity Type:Organization
Organization Name:H G HEEDER CHIROPRACTIC INC
Other - Org Name:GROWING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:HEEDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:619-291-5433
Mailing Address - Street 1:1452 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3405
Mailing Address - Country:US
Mailing Address - Phone:619-291-5433
Mailing Address - Fax:619-209-3608
Practice Address - Street 1:1452 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3405
Practice Address - Country:US
Practice Address - Phone:619-291-5433
Practice Address - Fax:619-209-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31694261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center