Provider Demographics
NPI:1780236125
Name:HEATH, KAYLEIGH (DC)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:HEATH
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 1:330 NAUBUC AVE
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1011
Mailing Address - Country:US
Mailing Address - Phone:860-410-4488
Mailing Address - Fax:860-410-4492
Practice Address - Street 1:330 NAUBUC AVE
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1011
Practice Address - Country:US
Practice Address - Phone:860-410-4488
Practice Address - Fax:860-410-4492
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor