Provider Demographics
NPI:1871732958
Name:HECKARD, BRUCE LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:LYNN
Last Name:HECKARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1708
Mailing Address - Country:US
Mailing Address - Phone:707-226-8683
Mailing Address - Fax:707-226-3160
Practice Address - Street 1:1427 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1708
Practice Address - Country:US
Practice Address - Phone:707-226-8683
Practice Address - Fax:707-226-3160
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor