Individual
DR. BRIAN DAVID HEEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
641 LATTON LN, PORTAGE, WI 53901-1078
(608) 742-1300
Mailing address
W8979 KENT RD, POYNETTE, WI 53955-9258
(608) 635-2200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4566-012
WI
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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