Provider Demographics
NPI:1538103890
Name:HESTON, THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HESTON
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 1:826 BUSTLETON PIKE
Mailing Address - Street 2:STE 101A
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6064
Mailing Address - Country:US
Mailing Address - Phone:215-357-8680
Mailing Address - Fax:215-357-0238
Practice Address - Street 1:826 BUSTLETON PIKE
Practice Address - Street 2:STE 101A
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053-6064
Practice Address - Country:US
Practice Address - Phone:215-357-8680
Practice Address - Fax:215-357-0238
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003251L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30645Medicare UPIN