Healthcare Provider Details
I. General information
NPI: 1720503170
Provider Name (Legal Business Name): HEPPE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
311 FREDERICK ST
FREDERICKSBURG VA
22401
US
IV. Provider business mailing address
311 FREDERICK ST
FREDERICKSBURG VA
22401-6025
US
V. Phone/Fax
- Phone: 540-840-4144
- Fax:
- Phone: 540-840-4144
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 0104-557280 |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
ERICA
GRACE
HEPPE
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 540-840-4144