Provider Demographics
NPI:1760411961
Name:HEINZE, DANE DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:DONALD
Last Name:HEINZE
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:PO BOX 2874
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42135-2874
Mailing Address - Country:US
Mailing Address - Phone:270-586-6900
Mailing Address - Fax:270-586-6966
Practice Address - Street 1:1248 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-8934
Practice Address - Country:US
Practice Address - Phone:270-586-6900
Practice Address - Fax:270-586-6966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001725Medicaid
KY85001725Medicaid
KYU86805Medicare UPIN