Provider Demographics
NPI:1639140080
Name:BUESGENS, JAMES D (DC, OTR, CHC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:BUESGENS
Suffix:
Gender:M
Credentials:DC, OTR, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 OLD TOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:ELKO NEW MARKET
Mailing Address - State:MN
Mailing Address - Zip Code:55054
Mailing Address - Country:US
Mailing Address - Phone:952-226-4325
Mailing Address - Fax:
Practice Address - Street 1:115 OLD TOWN ROAD
Practice Address - Street 2:
Practice Address - City:ELKO NEW MARKET
Practice Address - State:MN
Practice Address - Zip Code:55054
Practice Address - Country:US
Practice Address - Phone:952-226-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001904111N00000X
MN101110225X00000X
MN4326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3670444Medicare PIN