Provider Demographics
NPI:1508202532
Name:BUESING, CRYSTAL DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:DAWN
Last Name:BUESING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:DAWN
Other - Last Name:SATTERSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-0091
Mailing Address - Country:US
Mailing Address - Phone:563-271-0226
Mailing Address - Fax:888-603-4297
Practice Address - Street 1:419 N CODY RD
Practice Address - Street 2:
Practice Address - City:LE CLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-9537
Practice Address - Country:US
Practice Address - Phone:563-271-0226
Practice Address - Fax:888-603-4297
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB2819OtherMEDICARE PTAN