Healthcare Provider Details

I. General information

NPI: 1447594643
Provider Name (Legal Business Name): HEPPNER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2012
Last Update Date: 05/24/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 INSURANCE LN
CHARLOTTESVILLE VA
22911-7229
US

IV. Provider business mailing address

1544 INSURANCE LN STE 105
CHARLOTTESVILLE VA
22911-7229
US

V. Phone/Fax

Practice location:
  • Phone: 434-962-9310
  • Fax:
Mailing address:
  • Phone: 434-962-9310
  • Fax: 434-974-9182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104555816
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE HEPPNER
Title or Position: DOCTOR/BUSINESS OWNER
Credential: D.C.
Phone: 434-974-7955