Healthcare Provider Details

I. General information

NPI: 1841416948
Provider Name (Legal Business Name): HEYDINGER FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MILAN AVE. SUITE 3
NORWALK OH
44857-2513
US

IV. Provider business mailing address

295 MILAN AVE. SUITE 3
NORWALK OH
44857-2513
US

V. Phone/Fax

Practice location:
  • Phone: 419-668-8412
  • Fax:
Mailing address:
  • Phone: 419-668-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3726
License Number StateOH

VIII. Authorized Official

Name: DR. JASON ARTHUR HEYDINGER
Title or Position: CHIROPRACTOR, OWNER
Credential: D.C.
Phone: 419-668-8412