Provider Demographics
NPI:1497035455
Name:KUSSMAUL, MEGAN N (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:N
Last Name:KUSSMAUL
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:PO BOX 4
Mailing Address - Street 2:129 NORTH STREET
Mailing Address - City:MARQUETTE
Mailing Address - State:IA
Mailing Address - Zip Code:52158-0004
Mailing Address - Country:US
Mailing Address - Phone:563-873-5422
Mailing Address - Fax:563-873-5422
Practice Address - Street 1:129 NORTH ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:IA
Practice Address - Zip Code:52158-7706
Practice Address - Country:US
Practice Address - Phone:563-873-5422
Practice Address - Fax:563-873-5422
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085041111N00000X
WI4787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor