Provider Demographics
NPI:1316164973
Name:HEISLER, LLOYD COLE (DC)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:COLE
Last Name:HEISLER
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 1:1695 S FERDON BLVD
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-8447
Mailing Address - Country:US
Mailing Address - Phone:850-398-8985
Mailing Address - Fax:850-398-8978
Practice Address - Street 1:1695 S FERDON BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-8447
Practice Address - Country:US
Practice Address - Phone:850-398-8985
Practice Address - Fax:850-398-8978
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2206LOtherBCBS