Provider Demographics
NPI:1033071337
Name:ZEDONA HEALTHCARE LLC
Entity type:Organization
Organization Name:ZEDONA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KESTER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:OGALA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:509-440-4671
Mailing Address - Street 1:3239 WILLOW FIN WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-3198
Mailing Address - Country:US
Mailing Address - Phone:509-440-4671
Mailing Address - Fax:
Practice Address - Street 1:3239 WILLOW FIN WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3198
Practice Address - Country:US
Practice Address - Phone:509-440-4671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty