Provider Demographics
NPI:1295185221
Name:OEHLER, DUSTIN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:LEE
Last Name:OEHLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SHERIDAN PL
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1673
Mailing Address - Country:US
Mailing Address - Phone:651-666-8140
Mailing Address - Fax:
Practice Address - Street 1:7750 HARKNESS AVE S
Practice Address - Street 2:105
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-2063
Practice Address - Country:US
Practice Address - Phone:651-666-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor