Provider Demographics
NPI:1649392598
Name:BIESEMEYER, LOUIS W (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:W
Last Name:BIESEMEYER
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 1:517 SOUTH OAK
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:65711
Mailing Address - Country:US
Mailing Address - Phone:417-926-5841
Mailing Address - Fax:
Practice Address - Street 1:107 N TALCOTT
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711-1756
Practice Address - Country:US
Practice Address - Phone:417-926-5841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor