Provider Demographics
NPI:1497822175
Name:HEU, LEE ANDRE (DC)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANDRE
Last Name:HEU
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 1:3636 N 1ST ST
Mailing Address - Street 2:SUITE 123
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6800
Mailing Address - Country:US
Mailing Address - Phone:559-221-8180
Mailing Address - Fax:559-221-8187
Practice Address - Street 1:3636 N 1ST ST
Practice Address - Street 2:SUITE 123
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6800
Practice Address - Country:US
Practice Address - Phone:559-221-8180
Practice Address - Fax:559-221-8187
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0241410Medicaid
CADC0241410Medicaid