Provider Demographics
NPI:1588716054
Name:ALTLAND, HEATH ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:HEATH
Middle Name:ALAN
Last Name:ALTLAND
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 1:1345 STATE ROUTE 209
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-8208
Mailing Address - Country:US
Mailing Address - Phone:717-692-2349
Mailing Address - Fax:717-692-0312
Practice Address - Street 1:1345 STATE ROUTE 209
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-8208
Practice Address - Country:US
Practice Address - Phone:717-692-2349
Practice Address - Fax:717-692-0312
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAL098614Medicare ID - Type Unspecified