Provider Demographics
NPI:1942275755
Name:HEITMAN, CHRISTINA E (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:E
Last Name:HEITMAN
Suffix:
Gender:F
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:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-0739
Mailing Address - Country:US
Mailing Address - Phone:712-732-8527
Mailing Address - Fax:
Practice Address - Street 1:323 W MILWAUKEE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-1867
Practice Address - Country:US
Practice Address - Phone:712-732-8527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0190991Medicaid
IA0190991Medicaid