Provider Demographics
NPI:1447404132
Name:JOE, LESTER (DC)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:
Last Name:JOE
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 1:2380 MONTPELIER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1620
Mailing Address - Country:US
Mailing Address - Phone:408-888-0642
Mailing Address - Fax:
Practice Address - Street 1:2380 MONTPELIER DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1620
Practice Address - Country:US
Practice Address - Phone:408-888-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-08
Last Update Date:2008-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor