Provider Demographics
NPI:1316253800
Name:HEEDER, HAROLD GEORGE JR (DC)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:GEORGE
Last Name:HEEDER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2155 GREEN VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-8542
Mailing Address - Country:US
Mailing Address - Phone:775-337-0184
Mailing Address - Fax:775-337-2395
Practice Address - Street 1:2155 GREEN VISTA DR STE 202
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431
Practice Address - Country:US
Practice Address - Phone:775-337-0184
Practice Address - Fax:775-337-2395
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor