Provider Demographics
NPI:1982777272
Name:SWEET, HEATHER DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:DAWN
Last Name:SWEET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:DAWN
Other - Last Name:GANSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2850 W RAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9431
Mailing Address - Country:US
Mailing Address - Phone:414-855-3870
Mailing Address - Fax:414-855-3871
Practice Address - Street 1:2850 W RAWSON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9431
Practice Address - Country:US
Practice Address - Phone:414-855-3870
Practice Address - Fax:414-855-3871
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4032-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38953000Medicaid
WIV00352Medicare UPIN
WI000301234Medicare ID - Type Unspecified