Provider Demographics
NPI:1679611651
Name:ANNE M. HEISSERER, DC, LLC
Entity type:Organization
Organization Name:ANNE M. HEISSERER, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEISSERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LLC
Authorized Official - Phone:573-332-1111
Mailing Address - Street 1:3232 INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4904
Mailing Address - Country:US
Mailing Address - Phone:573-332-1111
Mailing Address - Fax:573-332-0042
Practice Address - Street 1:3232 INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4904
Practice Address - Country:US
Practice Address - Phone:573-332-1111
Practice Address - Fax:573-332-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty