Provider Demographics
NPI:1962571026
Name:HEIKKINEN, MARSHA KAY (DC, DICCP)
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:KAY
Last Name:HEIKKINEN
Suffix:
Gender:F
Credentials:DC, DICCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 ROSBURY CT
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-3540
Mailing Address - Country:US
Mailing Address - Phone:972-222-3737
Mailing Address - Fax:
Practice Address - Street 1:820 E CARTWRIGHT RD
Practice Address - Street 2:SUITE 133
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6063
Practice Address - Country:US
Practice Address - Phone:972-285-3232
Practice Address - Fax:972-285-5993
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82K732OtherBCBS PROVIDER NUMBER
TX82K732OtherBCBS PROVIDER NUMBER
00G14GMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER