Provider Demographics
NPI:1235328790
Name:HEINZE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HEINZE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINZE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-586-6900
Mailing Address - Street 1:PO BOX 2874
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42135-2874
Mailing Address - Country:US
Mailing Address - Phone:270-586-6900
Mailing Address - Fax:270-586-6966
Practice Address - Street 1:1248 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-8934
Practice Address - Country:US
Practice Address - Phone:270-586-6900
Practice Address - Fax:270-586-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9993Medicare PIN