Provider Demographics
NPI:1306890256
Name:HEIMENSEN, JEFFREY D (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:HEIMENSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ARIZONA AVE NW
Mailing Address - Street 2:HEIMENSEN FAMILY CHIROPRACTIC CENTER
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1425
Mailing Address - Country:US
Mailing Address - Phone:712-737-3850
Mailing Address - Fax:712-737-3859
Practice Address - Street 1:111 ARIZONA AVE NW
Practice Address - Street 2:HEIMENSEN FAMILY CHIROPRACTIC CENTER
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1425
Practice Address - Country:US
Practice Address - Phone:712-737-3850
Practice Address - Fax:712-737-3859
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0143776Medicaid
IA54891OtherWELLMARK BCBS
IA34805OtherSIOUX VALLEY HEALTH
IA4642OtherMIDLANDS CHOICE
IA54891Medicare ID - Type Unspecified
IA4642OtherMIDLANDS CHOICE