Provider Demographics
NPI:1396739728
Name:HESS, MICHAEL DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:HESS
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 1:58 LEE PLACE
Mailing Address - Street 2:C
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5519
Mailing Address - Country:US
Mailing Address - Phone:434-544-1811
Mailing Address - Fax:434-239-4346
Practice Address - Street 1:20607 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7206
Practice Address - Country:US
Practice Address - Phone:434-239-9077
Practice Address - Fax:434-239-4346
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4834111N00000X
VA0104556449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU98418Medicare UPIN