Provider Demographics
NPI:1346710894
Name:HESKETT, ADAM (DC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HESKETT
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 1:1703 HIGHWAY 121 BYP N
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8853
Mailing Address - Country:US
Mailing Address - Phone:404-630-1240
Mailing Address - Fax:
Practice Address - Street 1:1703 HIGHWAY 121 BYP N
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8853
Practice Address - Country:US
Practice Address - Phone:404-630-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty