Provider Demographics
NPI:1275400772
Name:HEATH, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HEATH
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 1:5663 N GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714-1339
Mailing Address - Country:US
Mailing Address - Phone:717-961-1013
Mailing Address - Fax:
Practice Address - Street 1:5663 N GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:ID
Practice Address - Zip Code:83714-1339
Practice Address - Country:US
Practice Address - Phone:717-961-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID7371281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor