| Healthsource Chiropractic Of Pasco | |
|
1211 N 20th Ave, Pasco, WA 99301-4051 | |
| (509) 547-1759 | |
| Not Available |
| Full Name | Healthsource Chiropractic Of Pasco |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1211 N 20th Ave, Pasco, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093227977 | NPI | - | NPPES |
| 0403568 | Other | WA | LNI NUMBER |
| 60789723 | Other | WA | CHIROPRACTIC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 60789723 (Washington) | Primary |
| Provider Name | Jonathon Merrell Heslop |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1851800593 PECOS PAC ID: 2466719471 Enrollment ID: I20171129003154 |
| Provider Name | Candelario Lopez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1720701584 PECOS PAC ID: 8123482106 Enrollment ID: I20230908002135 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Chiropractic Of Pasco 1211 N 20th Ave, Pasco, WA 99301-4051 Ph: (509) 547-1759 | Healthsource Chiropractic Of Pasco 1211 N 20th Ave, Pasco, WA 99301-4051 Ph: (509) 547-1759 |
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