Provider Demographics
NPI:1316450331
Name:HELLER, SUSAN WATSON (DC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:WATSON
Last Name:HELLER
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 1:519 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4019
Mailing Address - Country:US
Mailing Address - Phone:202-714-0125
Mailing Address - Fax:
Practice Address - Street 1:38 E 5TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3415
Practice Address - Country:US
Practice Address - Phone:303-863-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor