Provider Demographics
NPI:1447079918
Name:DR HEATHER BANVILLE PLLC
Entity type:Organization
Organization Name:DR HEATHER BANVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BANVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-231-5653
Mailing Address - Street 1:31 ENSIGN SPENCE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5558
Mailing Address - Country:US
Mailing Address - Phone:610-331-0147
Mailing Address - Fax:
Practice Address - Street 1:3709 STRAWBERRY PLAINS RD STE A
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-3424
Practice Address - Country:US
Practice Address - Phone:610-331-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty