Healthcare Provider Details

I. General information

NPI: 1750563078
Provider Name (Legal Business Name): HEUSER CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 W 32ND ST
YUMA AZ
85364-8127
US

IV. Provider business mailing address

144 W 32ND ST
YUMA AZ
85364-8127
US

V. Phone/Fax

Practice location:
  • Phone: 928-726-8847
  • Fax: 928-341-0417
Mailing address:
  • Phone: 928-726-8847
  • Fax: 928-341-0417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3410
License Number StateAZ

VIII. Authorized Official

Name: DR. CHARLES HEUSER
Title or Position: OWNER
Credential: D.C.
Phone: 928-726-8847