Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OPT.0003515 | CO |
Y | 152W00000X | Optometrist | S-A82-TA-661 | AL |
NPI | 1003918921 |
---|---|
Provider Name | Dr. Kristen Elizabeth Heck |
First Address | Colorado Springs, CO 80907-7525 |
Second Address | Sylacauga, AL 35150-8046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 19/08/2019 |