Provider Demographics
NPI:1538457767
Name:HEINRICH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEINRICH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-358-9734
Mailing Address - Street 1:6420 ASHBURN LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-4185
Mailing Address - Country:US
Mailing Address - Phone:303-358-9734
Mailing Address - Fax:
Practice Address - Street 1:5600 W DARTMOUTH AVE
Practice Address - Street 2:#104
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-5546
Practice Address - Country:US
Practice Address - Phone:303-985-5557
Practice Address - Fax:303-985-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6519305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service