Provider Demographics
NPI:1215999172
Name:DOREY, HEATHER A (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:A
Last Name:DOREY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 HASLETT RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8691
Mailing Address - Country:US
Mailing Address - Phone:517-339-3737
Mailing Address - Fax:517-339-3737
Practice Address - Street 1:1640 HASLETT RD
Practice Address - Street 2:SUITE 140
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8691
Practice Address - Country:US
Practice Address - Phone:517-339-3737
Practice Address - Fax:517-339-3737
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI144756370Medicaid
MI950C313200OtherBCBS PROVIDER NUMBER
MI0P16460Medicare PIN
MI144756370Medicaid