Healthcare Provider Details

I. General information

NPI: 1295824472
Provider Name (Legal Business Name): HEATHER L GEHLING DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 E BREMER AVE
WAVERLY IA
50677-3316
US

IV. Provider business mailing address

96 E BREMER AVE
WAVERLY IA
50677-3316
US

V. Phone/Fax

Practice location:
  • Phone: 319-352-1222
  • Fax: 319-352-1222
Mailing address:
  • Phone: 319-352-1222
  • Fax: 319-352-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007157
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: