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Individual

DR. CLARK D HELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1221 PHOENIX ST, DELAVAN, WI 53115-2340
(262) 728-8208
(262) 728-9818
Mailing address
1221 PHOENIX ST, DELAVAN, WI 53115-2340
(262) 728-8208
(262) 728-9818

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4069-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000535686
PTAN
WI
Enumeration date
04/09/2007
Last updated
12/07/2009
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