Healthcare Provider Details

I. General information

NPI: 1538422258
Provider Name (Legal Business Name): HEUN CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JEFFERSON ST
NAPA CA
94559-1214
US

IV. Provider business mailing address

2000 JEFFERSON ST
NAPA CA
94559-1214
US

V. Phone/Fax

Practice location:
  • Phone: 707-255-4424
  • Fax:
Mailing address:
  • Phone: 707-255-4424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15236
License Number StateCA

VIII. Authorized Official

Name: DR. SCOTT JOSEPH HEUN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 707-255-4424