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General NPI Number Information
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NPI Number | 1861556813
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Entity Type | Individual
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Provider Name | DONNA KATHREEN HEITZMAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 241 COMMERCIAL ST WHALERS WHARF
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City | PROVINCETOWN
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State | MA
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Zip | 02657-2102
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Country | US
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Telephone | 508-487-3799
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Fax | 508-487-3799
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Provider Business Mailing Address
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Address Line | 160 KENWOOD AVE
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City | SYRACUSE
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State | NY
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Zip | 13208
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Country | US
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Telephone | 315-663-1939
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Fax | 315-663-1939
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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 | 3539
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 770
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License Number State | MA
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