Provider Demographics
NPI:1720579790
Name:HEINRICH CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:HEINRICH CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-652-2804
Mailing Address - Street 1:620 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-3064
Mailing Address - Country:US
Mailing Address - Phone:563-652-2804
Mailing Address - Fax:563-652-7072
Practice Address - Street 1:620 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060
Practice Address - Country:US
Practice Address - Phone:563-652-2804
Practice Address - Fax:563-652-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty