Provider Demographics
NPI:1861526444
Name:HECK, RONALD CLYDE (DC)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:CLYDE
Last Name:HECK
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 1:120 S GILMER ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3602
Mailing Address - Country:US
Mailing Address - Phone:770-386-7576
Mailing Address - Fax:770-386-7360
Practice Address - Street 1:120 S GILMER ST
Practice Address - Street 2:SUITE C
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3602
Practice Address - Country:US
Practice Address - Phone:770-386-7576
Practice Address - Fax:770-386-7360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO0002648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor