Provider Demographics
NPI:1245303544
Name:GIESEN, HEATHER L (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:GIESEN
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 1:815 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-2498
Mailing Address - Country:US
Mailing Address - Phone:952-758-8760
Mailing Address - Fax:952-758-8761
Practice Address - Street 1:815 1ST ST SE
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-2498
Practice Address - Country:US
Practice Address - Phone:952-758-8760
Practice Address - Fax:952-758-8761
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN421L0BJOtherBLUE CROSS BLUE SHIELD
MN350003287OtherMEDICARE
MNV03606Medicare UPIN