Healthcare Provider Details

I. General information

NPI: 1578669263
Provider Name (Legal Business Name): JON P HEINS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKFIELD GLEN DR SUITE B
BELVIDERE NJ
07823-2854
US

IV. Provider business mailing address

PO BOX 131
BELVIDERE NJ
07823
US

V. Phone/Fax

Practice location:
  • Phone: 908-475-2933
  • Fax: 908-475-4225
Mailing address:
  • Phone: 908-475-2933
  • Fax: 908-475-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00522400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: