Healthcare Provider Details

I. General information

NPI: 1427391895
Provider Name (Legal Business Name): HEATHER ELAINE CLIFF D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER CASEY DC

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 COBB PKWY S STE 190
MARIETTA GA
30060-6500
US

IV. Provider business mailing address

950 COBB PKWY S STE 190
MARIETTA GA
30060-6500
US

V. Phone/Fax

Practice location:
  • Phone: 770-427-7387
  • Fax: 770-426-1491
Mailing address:
  • Phone: 770-427-7387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6767
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: