Provider Demographics
NPI:1114095007
Name:HEIGL, CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:HEIGL
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 1:3838 W DORY CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9099
Mailing Address - Country:US
Mailing Address - Phone:262-215-7246
Mailing Address - Fax:
Practice Address - Street 1:3838 W DORY CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9099
Practice Address - Country:US
Practice Address - Phone:262-215-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2336-012111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI76144192OtherWAUSAU
WI76144192OtherWAUSAU