Provider Demographics
NPI:1386624161
Name:HENG, BRUCE J (DC, MED)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:J
Last Name:HENG
Suffix:
Gender:M
Credentials:DC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S BOULEVARD ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5144
Mailing Address - Country:US
Mailing Address - Phone:405-340-1086
Mailing Address - Fax:405-340-0750
Practice Address - Street 1:1700 S BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5144
Practice Address - Country:US
Practice Address - Phone:405-340-1086
Practice Address - Fax:405-340-0750
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKQDBXGMedicare ID - Type Unspecified