Provider Demographics
NPI:1386002079
Name:HECKER, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:HECKER
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 1:500 ELM GROVE RD
Mailing Address - Street 2:# 325
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2546
Mailing Address - Country:US
Mailing Address - Phone:262-782-1616
Mailing Address - Fax:
Practice Address - Street 1:500 ELM GROVE RD
Practice Address - Street 2:# 325
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2546
Practice Address - Country:US
Practice Address - Phone:262-782-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5163-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor