Individual
DR. HEATHER L CHESTELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
407 S MAIN ST, VIROQUA, WI 54665-2100
(608) 637-3195
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005341
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
964
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
964-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710175997
—
WI
Enumeration date
10/12/2007
Last updated
06/04/2015
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