Provider Demographics
NPI:1255894135
Name:MCQUEARY, DUSTIN LEVI (DC)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:LEVI
Last Name:MCQUEARY
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 1:206 DOHONEY TRCE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-5532
Mailing Address - Country:US
Mailing Address - Phone:270-380-1713
Mailing Address - Fax:270-380-1714
Practice Address - Street 1:206 DOHONEY TRCE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-5532
Practice Address - Country:US
Practice Address - Phone:270-380-1713
Practice Address - Fax:270-380-1714
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor