Healthcare Provider Details

I. General information

NPI: 1174046288
Provider Name (Legal Business Name): JOSEPH R. HESTON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 LINCOLN AVE
DUBUQUE IA
52001-1421
US

IV. Provider business mailing address

2015 LINCOLN AVE
DUBUQUE IA
52001-1421
US

V. Phone/Fax

Practice location:
  • Phone: 563-451-9938
  • Fax:
Mailing address:
  • Phone: 563-451-9938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number087967
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number347
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: