Provider Demographics
NPI:1639616691
Name:HETTERSCHEIDT, MICHAEL ASHTON (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ASHTON
Last Name:HETTERSCHEIDT
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:10807 NEW ALLEGIANCE DR STE 160
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3805
Practice Address - Country:US
Practice Address - Phone:719-249-3547
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor