Provider Demographics
NPI:1881117588
Name:HEFFNEY, MAURICE ROY
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:ROY
Last Name:HEFFNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BONANZA DR
Mailing Address - Street 2:113, PLATINUM KUTZ
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-6313
Mailing Address - Country:US
Mailing Address - Phone:910-751-9357
Mailing Address - Fax:
Practice Address - Street 1:155 BONANZA DR
Practice Address - Street 2:113, PLATINUM KUTZ
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-2767
Practice Address - Country:US
Practice Address - Phone:910-751-9357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management