Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH0005488 | FL |
N | 111NN0400X | Neurology | CH0005488 | FL |
N | 111NN1001X | Nutrition | CH0005488 | FL |
NPI | 1366505687 |
---|---|
Provider Name | Bill G Heyser |
First Address | Tallahassee, FL 32308 |
Second Address | Tallahassee, FL 32308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 10/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T54817 | (02) | FL |