Healthcare Provider Details

I. General information

NPI: 1699084095
Provider Name (Legal Business Name): SEAN XAVIER HESLER ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2010
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 E BROADWAY RD
TEMPE AZ
85282
US

IV. Provider business mailing address

1051 S DOBSON RD #124
MESA AZ
85202
US

V. Phone/Fax

Practice location:
  • Phone: 925-290-8610
  • Fax:
Mailing address:
  • Phone: 925-290-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number10-1209
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: