Provider Demographics
NPI:1508911900
Name:HEINRICH, CRAIG MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MICHAEL
Last Name:HEINRICH
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 1:61 COMMERCE AVE SW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4124
Mailing Address - Country:US
Mailing Address - Phone:616-940-0660
Mailing Address - Fax:616-940-1965
Practice Address - Street 1:2199 JOLLY RD
Practice Address - Street 2:SUITE 140
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3968
Practice Address - Country:US
Practice Address - Phone:517-381-1880
Practice Address - Fax:517-381-1990
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P46230Medicare PIN