Provider Demographics
NPI:1780398834
Name:HEATH, HILARY (DC)
Entity type:Individual
Prefix:DR
First Name:HILARY
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 1:9030 W FORT ISLAND TRL STE 11A
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-2415
Mailing Address - Country:US
Mailing Address - Phone:386-290-0804
Mailing Address - Fax:
Practice Address - Street 1:9030 W FORT ISLAND TRL STE 11A
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-2415
Practice Address - Country:US
Practice Address - Phone:386-290-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor