Provider Demographics
NPI:1083859961
Name:VERLYN W HEINE DC PC
Entity type:Organization
Organization Name:VERLYN W HEINE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VERLYN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-440-3824
Mailing Address - Street 1:160 AUGUSTA CIR
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-9256
Mailing Address - Country:US
Mailing Address - Phone:319-352-4652
Mailing Address - Fax:319-352-4652
Practice Address - Street 1:2024 3RD AVE NW
Practice Address - Street 2:SUITE B
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2066
Practice Address - Country:US
Practice Address - Phone:319-440-3824
Practice Address - Fax:319-352-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1336239748OtherPERSONAL NPI #1336239748