Healthcare Provider Details

I. General information

NPI: 1770341976
Provider Name (Legal Business Name): NICHOLAS HEUKER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 MAIN ST
MILFORD OH
45150-1786
US

IV. Provider business mailing address

777 MAIN ST
MILFORD OH
45150-1786
US

V. Phone/Fax

Practice location:
  • Phone: 513-831-3800
  • Fax:
Mailing address:
  • Phone: 513-831-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5337
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: