Provider Demographics
NPI:1760892509
Name:KESSLER, ELIZABETH BUYSE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BUYSE
Last Name:KESSLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:CHRISTINE
Other - Last Name:BUYSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8900 109TH AVE N
Mailing Address - Street 2:SUITE #700
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3164
Mailing Address - Country:US
Mailing Address - Phone:763-807-6817
Mailing Address - Fax:
Practice Address - Street 1:8900 109TH AVE N
Practice Address - Street 2:SUITE 700
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3164
Practice Address - Country:US
Practice Address - Phone:763-807-6817
Practice Address - Fax:763-390-6639
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400139075Medicare PIN