=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447594643
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEPPNER P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2012
-----------------------------------------------------
Last Update Date | 05/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1544 INSURANCE LN
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22911-7229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-962-9310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1544 INSURANCE LN STE 105
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22911-7229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-962-9310
-----------------------------------------------------
Fax | 434-974-9182
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR/BUSINESS OWNER
-----------------------------------------------------
Name | DR. MICHELLE HEPPNER
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 434-974-7955
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 0104555816
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------