Provider Demographics
NPI:1871537522
Name:COCO, HEATHER MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MARIE
Last Name:COCO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:WILT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:552 ASHTON CT
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3689
Mailing Address - Country:US
Mailing Address - Phone:412-523-2712
Mailing Address - Fax:724-327-1334
Practice Address - Street 1:4540 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668
Practice Address - Country:US
Practice Address - Phone:724-327-1333
Practice Address - Fax:724-327-1334
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ009136111N00000X
PADC009327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027570400001Medicaid
PA247336YD23Medicare PIN