Provider Demographics
NPI:1912089228
Name:ROGERS KING, HEATHER ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANN
Last Name:ROGERS KING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2717 N GRANDVIEW BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1672
Mailing Address - Country:US
Mailing Address - Phone:262-349-9370
Mailing Address - Fax:262-349-9729
Practice Address - Street 1:2717 N GRANDVIEW BLVD
Practice Address - Street 2:STE 101
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1672
Practice Address - Country:US
Practice Address - Phone:262-309-6795
Practice Address - Fax:262-309-6795
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3659-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor