Provider Demographics
NPI:1568123669
Name:GESSELL, LEXI (DC)
Entity Type:Individual
Prefix:
First Name:LEXI
Middle Name:
Last Name:GESSELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LEXI
Other - Middle Name:
Other - Last Name:BANWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1201 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3490
Mailing Address - Country:US
Mailing Address - Phone:319-242-1223
Mailing Address - Fax:
Practice Address - Street 1:41025 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:BOVEY
Practice Address - State:MN
Practice Address - Zip Code:55709-7062
Practice Address - Country:US
Practice Address - Phone:218-245-2176
Practice Address - Fax:218-245-2676
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor