Provider Demographics
NPI:1255753190
Name:HEFFELMIRE, ANDREW LEE (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LEE
Last Name:HEFFELMIRE
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 1:13341 BADEN DR
Mailing Address - Street 2:APT #101
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7737
Mailing Address - Country:US
Mailing Address - Phone:217-414-5778
Mailing Address - Fax:
Practice Address - Street 1:5750 E 91ST ST
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1380
Practice Address - Country:US
Practice Address - Phone:317-284-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002754A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor