Individual
DR. IAN HEINICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
23211 RED ARROW HWY, MATTAWAN, MI 49071-9701
(269) 668-5930
Mailing address
980 NIAGARA DR, LAWTON, MI 49065-9532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018840
MI
Other
Enumeration date
08/27/2018
Last updated
04/16/2023
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