Healthcare Provider Details
I. General information
NPI: 1699885608
Provider Name (Legal Business Name): GREGORY RAY HEYART D.C..
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 TOWER WAY SUITE 130
BAKERSFIELD CA
93309
US
IV. Provider business mailing address
1001 TOWER WAY SUITE 130
BAKERSFIELD CA
93309
US
V. Phone/Fax
- Phone: 661-327-2622
- Fax: 661-327-2622
- Phone: 661-327-2622
- Fax: 661-327-0614
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN0400X |
| Taxonomy | Neurology Chiropractor |
| License Number | DC16121 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | DC16121 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0200X |
| Taxonomy | Radiology Chiropractor |
| License Number | DC16121 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC161210 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: