Provider Demographics
NPI:1518915586
Name:HEUSER, CHARLES HERMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HERMAN
Last Name:HEUSER
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 1:1356 N. ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2713
Mailing Address - Country:US
Mailing Address - Phone:719-574-6006
Mailing Address - Fax:719-574-7365
Practice Address - Street 1:1356 N. ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2713
Practice Address - Country:US
Practice Address - Phone:757-574-6006
Practice Address - Fax:719-574-7365
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0001234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCM0903Medicare UPIN