Provider Demographics
NPI:1013132349
Name:LESTER, WALTER ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ANDREW
Last Name:LESTER
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 1:125 ORANGE ST # 3
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-4028
Mailing Address - Country:US
Mailing Address - Phone:917-664-0425
Mailing Address - Fax:917-664-0425
Practice Address - Street 1:125 ORANGE ST # 3
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-4028
Practice Address - Country:US
Practice Address - Phone:917-664-0425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor