Heaton, Bob Phillip

Heaton, Bob Phillip is an sole proprietor health care provider with primary practice located at 1320 S Ammon Road , Idaho Falls ID 83406-5810. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Heaton, Bob Phillip can be contacted via phone (208) 529-2084.

Contact Information

Primary practice address
1320 S Ammon Road Idaho Falls ID 83406-5810
Fax: (208) 529-2084
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CHIA 369 Idaho

Profile Details

NPI number 1083688030
LBN Legal business name Heaton, Bob Phillip
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2006
Last updated Jan 24th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083688030 NPPES
Idaho MEDICAID 000953900
Idaho Other 000010008077

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