Provider Demographics
NPI:1710089156
Name:BUYS, JOEL DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:DAVID
Last Name:BUYS
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 1:7661 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014
Mailing Address - Country:US
Mailing Address - Phone:651-784-4423
Mailing Address - Fax:651-784-7737
Practice Address - Street 1:7661 LAKE DR
Practice Address - Street 2:
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55014
Practice Address - Country:US
Practice Address - Phone:651-784-4423
Practice Address - Fax:651-784-7737
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNT39570Medicare UPIN
MNC02940Medicare PIN