Provider Demographics
NPI:1891806923
Name:HECK, BRANDON GERHARDT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:GERHARDT
Last Name:HECK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 S MARION RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1349
Mailing Address - Country:US
Mailing Address - Phone:605-361-2500
Mailing Address - Fax:605-362-1930
Practice Address - Street 1:3600 S MARION RD
Practice Address - Street 2:SUITE #101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1349
Practice Address - Country:US
Practice Address - Phone:605-361-2500
Practice Address - Fax:605-362-1930
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7601652Medicaid
SD102304Medicare Oscar/Certification