Provider Demographics
NPI:1922387646
Name:HEATER CHIROPRACTIC, LC
Entity Type:Organization
Organization Name:HEATER CHIROPRACTIC, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:HEATER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-525-3400
Mailing Address - Street 1:724 NW COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5710
Mailing Address - Country:US
Mailing Address - Phone:816-525-3400
Mailing Address - Fax:816-525-3808
Practice Address - Street 1:724 NW COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5710
Practice Address - Country:US
Practice Address - Phone:816-525-3400
Practice Address - Fax:816-525-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011019802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty