Provider Demographics
NPI:1215298815
Name:HESTERA CHIROPRACTIC
Entity type:Organization
Organization Name:HESTERA CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HESTERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-898-5353
Mailing Address - Street 1:10050 RALSTON RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-4974
Mailing Address - Country:US
Mailing Address - Phone:720-898-5353
Mailing Address - Fax:720-898-0707
Practice Address - Street 1:10050 RALSTON RD
Practice Address - Street 2:SUITE E
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4974
Practice Address - Country:US
Practice Address - Phone:720-898-5353
Practice Address - Fax:720-898-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty