Provider Demographics
NPI:1396331922
Name:ZOOK, HEIDI KAY (DC)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:KAY
Last Name:ZOOK
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 1:2302 PRAIRIE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-2270
Mailing Address - Country:US
Mailing Address - Phone:763-682-5306
Mailing Address - Fax:763-684-1758
Practice Address - Street 1:109 2ND ST S
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1413
Practice Address - Country:US
Practice Address - Phone:763-682-5306
Practice Address - Fax:763-684-1758
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor