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General NPI Number Information
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NPI Number | 1568555142
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Entity Type | Individual
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Provider Name | GREGORY B HEYWOOD D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 225 30TH ST SUITE 208
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City | SACRAMENTO
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State | CA
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Zip | 95816-3359
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Country | US
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Telephone | 916-444-8390
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Fax | 916-444-1938
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Provider Business Mailing Address
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Address Line | 9700 RIO VISTA DR
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City | SACRAMENTO
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State | CA
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Zip | 95837-1005
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Country | US
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Telephone | 916-921-2806
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Fax | 916-927-2164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11204
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License Number State | CA
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