MEDICARE: HEIM CHIROPRACTIC, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2712	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2C924HE	OTHER	MN	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073675047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIM CHIROPRACTIC, PA

Provider Business Mailing Address
First Line	:	550 40TH AVE NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3835
Country	:	US
Telephone Number	:	651-482-9160
Fax Number	:	651-925-0053

Provider Business Practice Location Address
First Line	:	550 40TH AVE NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3835
Country	:	US
Telephone Number	:	651-482-9160
Fax Number	:	651-925-0053

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DEBORAH MARY HEIM
Credential	:	D.C.
Telephone Number	:	651-482-9160

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	02/23/2015

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