Provider Demographics
NPI:1457472771
Name:BUSSE, DARIN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:WAYNE
Last Name:BUSSE
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 1:2525 W 16TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4951
Mailing Address - Country:US
Mailing Address - Phone:970-352-9277
Mailing Address - Fax:970-352-9428
Practice Address - Street 1:2525 W 16TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4903
Practice Address - Country:US
Practice Address - Phone:970-352-9277
Practice Address - Fax:970-352-9428
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC504888Medicare ID - Type Unspecified