Provider Demographics
NPI:1376776773
Name:KREUSEL, KORY LANDON (DC)
Entity type:Individual
Prefix:
First Name:KORY
Middle Name:LANDON
Last Name:KREUSEL
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 1:610 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5452
Mailing Address - Country:US
Mailing Address - Phone:307-393-3903
Mailing Address - Fax:
Practice Address - Street 1:801 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5448
Practice Address - Country:US
Practice Address - Phone:307-324-7000
Practice Address - Fax:307-939-8386
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1378111N00000X
WY823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor