Provider Demographics
NPI:1851619381
Name:HEATHER B FAYE PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:HEATHER B FAYE PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:BRIGID
Authorized Official - Last Name:FAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-470-1225
Mailing Address - Street 1:10801 NATIONAL BLVD
Mailing Address - Street 2:#340
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4139
Mailing Address - Country:US
Mailing Address - Phone:310-470-1225
Mailing Address - Fax:310-475-8204
Practice Address - Street 1:10801 NATIONAL BLVD
Practice Address - Street 2:#340
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:310-470-1225
Practice Address - Fax:310-475-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty