Individual
ANDREW J HEIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCSP
Contact information
Practice address
2225 E CENTRE AVE, PORTAGE, MI 49002-4421
(269) 324-0100
Mailing address
2225 E CENTRE AVE, PORTAGE, MI 49002-4421
(269) 324-0100
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
6816
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269464414
—
MI
01
—
MI5489001
MEDICARE PTAN
MI
Enumeration date
11/29/2005
Last updated
06/17/2014
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