Provider Demographics
NPI:1316231236
Name:HESLIP, MARK ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:HESLIP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 PINE ST
Mailing Address - Street 2:SUIT 103
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3327
Mailing Address - Country:US
Mailing Address - Phone:415-989-7200
Mailing Address - Fax:
Practice Address - Street 1:369 PINE ST
Practice Address - Street 2:SUIT 103
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3327
Practice Address - Country:US
Practice Address - Phone:415-989-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22001111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation