Provider Demographics
NPI:1962155713
Name:THORN, HEATHER (HIS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:THORN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-1530
Mailing Address - Country:US
Mailing Address - Phone:641-895-6160
Mailing Address - Fax:
Practice Address - Street 1:5300 EDGEWOOD RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52411-4707
Practice Address - Country:US
Practice Address - Phone:319-363-0867
Practice Address - Fax:563-726-7383
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist