Provider Demographics
NPI:1275772733
Name:ALTO, KRYSTAL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:MARIE
Last Name:ALTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10880 175TH CT W
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-8781
Mailing Address - Country:US
Mailing Address - Phone:952-693-8798
Mailing Address - Fax:
Practice Address - Street 1:10880 175TH CT W STE 120
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-7493
Practice Address - Country:US
Practice Address - Phone:952-693-8798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor