Provider Demographics
NPI:1336480367
Name:HESS, DUANE RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:RAY
Last Name:HESS
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 1:343 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEISER
Mailing Address - State:ID
Mailing Address - Zip Code:83672-2515
Mailing Address - Country:US
Mailing Address - Phone:208-414-3333
Mailing Address - Fax:
Practice Address - Street 1:343 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEISER
Practice Address - State:ID
Practice Address - Zip Code:83672-2515
Practice Address - Country:US
Practice Address - Phone:208-414-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60326729111N00000X
IDCHIA-1543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor