Provider Demographics
NPI:1134445984
Name:HETTICK, WARNER MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:WARNER
Middle Name:MARTIN
Last Name:HETTICK
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 1:12061 TEJON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2325
Mailing Address - Country:US
Mailing Address - Phone:303-457-0123
Mailing Address - Fax:303-252-4065
Practice Address - Street 1:12061 TEJON ST STE 600
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2325
Practice Address - Country:US
Practice Address - Phone:303-457-0123
Practice Address - Fax:303-252-4065
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60141578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor