Provider Demographics
NPI:1821520917
Name:HESTER, STERLING JR (PTA CERTIFICATE)
Entity Type:Individual
Prefix:MR
First Name:STERLING
Middle Name:
Last Name:HESTER
Suffix:JR
Gender:M
Credentials:PTA CERTIFICATE
Other - Prefix:MR
Other - First Name:LAYLAN
Other - Middle Name:
Other - Last Name:HESTER
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PTA CERTIFICATE
Mailing Address - Street 1:16020 N 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3746
Mailing Address - Country:US
Mailing Address - Phone:623-329-2473
Mailing Address - Fax:
Practice Address - Street 1:16020 N 90TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3746
Practice Address - Country:US
Practice Address - Phone:623-329-2473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12878A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant