Provider Demographics
NPI:1245291293
Name:BECKETT, HEATHER K (DC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:BECKETT
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 3701
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34692-0701
Mailing Address - Country:US
Mailing Address - Phone:727-834-9945
Mailing Address - Fax:727-834-9945
Practice Address - Street 1:8614 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4945
Practice Address - Country:US
Practice Address - Phone:727-841-8488
Practice Address - Fax:727-848-5227
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
55708Medicare ID - Type Unspecified
U86544Medicare UPIN