MEDICARE: SAMUEL BRIAN HESTER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6025	AZ

General Provider Information

NPI Number	:	1033110846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL BRIAN HESTER DC

Provider Business Mailing Address
First Line	:	41930 N VENTURE DR
Second Line	:	STE 110
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3858
Country	:	US
Telephone Number	:	623-680-4496
Fax Number	:	623-551-9103

Provider Business Practice Location Address
First Line	:	42104 N VENTURE DR
Second Line	:	A-102
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3823
Country	:	US
Telephone Number	:	623-551-9100
Fax Number	:	623-551-9103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	04/13/2017

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