Provider Demographics
NPI:1497989073
Name:HETZ MANAGEMENT, S.C.
Entity Type:Organization
Organization Name:HETZ MANAGEMENT, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HETZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-547-7441
Mailing Address - Street 1:1720 DOLPHIN DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1489
Mailing Address - Country:US
Mailing Address - Phone:262-547-7441
Mailing Address - Fax:262-547-1971
Practice Address - Street 1:1720 DOLPHIN DR
Practice Address - Street 2:SUITE E
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1489
Practice Address - Country:US
Practice Address - Phone:262-547-7441
Practice Address - Fax:262-547-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4272-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty