MEDICARE: DR. DANE MICHAEL HEID D.C.

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	931	ND

General Provider Information

NPI Number	:	1407192362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANE MICHAEL HEID D.C.

Provider Business Mailing Address
First Line	:	3000 N 14TH ST
Second Line	:	3A
City	:	BISMARCK
State	:	ND
Zip	:	58503-0697
Country	:	US
Telephone Number	:	701-751-3070
Fax Number	:	701-751-3071

Provider Business Practice Location Address
First Line	:	3000 N 14TH ST
Second Line	:	3A
City	:	BISMARCK
State	:	ND
Zip	:	58503-0697
Country	:	US
Telephone Number	:	701-751-3070
Fax Number	:	701-751-3071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	12/21/2012

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