Organization
HEIB CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW J HEIB CCSP (CHIROPRACTOR)
(269) 324-0100
Entity
Organization
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
—
MI5489
MEDICARE PTAN
MI
Enumeration date
02/22/2012
Last updated
05/22/2012
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