Provider Demographics
NPI:1922211093
Name:BUESSING, WAYNE DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:DOUGLAS
Last Name:BUESSING
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 1:1970 DOMINION WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1465
Mailing Address - Country:US
Mailing Address - Phone:719-599-4343
Mailing Address - Fax:719-599-8044
Practice Address - Street 1:1970 DOMINION WAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1465
Practice Address - Country:US
Practice Address - Phone:719-599-4343
Practice Address - Fax:719-599-8044
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801285Medicare PIN