Individual
DR. MARK ROBERT HEINTZKILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3509 DEWEY ST, MANITOWOC, WI 54220-5813
(920) 686-5732
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1697012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38896400
—
WI
Enumeration date
12/11/2006
Last updated
09/04/2024
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