# HEINEN CHIROPRACTIC, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518007756
- **Authorized official:** DR. KENNETH SCOTT HEINEN D.C. (PRESIDENT)
- **Authorized official phone:** (920) 451-9960

## Contact information

- **Practice address:** 2103 INDIANA AVE STE 1A, SHEBOYGAN, WI 53081-4729
- **Practice address phone:** (920) 451-9960
- **Practice address fax:** (920) 451-9965
- **Mailing address:** 2103 INDIANA AVE STE 1A, SHEBOYGAN, WI 53081-4729
- **Mailing address phone:** (920) 451-9960
- **Mailing address fax:** (920) 451-9965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | WI | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38927500 | — | WI |