Provider Demographics
NPI:1598065062
Name:VANBUSKIRK, JOSHUA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LEE
Last Name:VANBUSKIRK
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 1:3751 N BUTLER AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6425
Mailing Address - Country:US
Mailing Address - Phone:505-609-8115
Mailing Address - Fax:505-393-1700
Practice Address - Street 1:3751 N BUTLER AVE STE 103
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6425
Practice Address - Country:US
Practice Address - Phone:505-609-8115
Practice Address - Fax:505-393-1700
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor