Healthcare Provider Details

I. General information

NPI: 1275858276
Provider Name (Legal Business Name): NEIL JOHN HEUKER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 OLDE WORTHINGTON RD STE 200
WESTERVILLE OH
43082-9127
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 210-477-7654
  • Fax: 210-468-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4055
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: