Provider Demographics
NPI:1912327917
Name:BUESGENS, BRANDON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:BUESGENS
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:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-0558
Mailing Address - Country:US
Mailing Address - Phone:952-457-3309
Mailing Address - Fax:
Practice Address - Street 1:13952 FIRST STREET
Practice Address - Street 2:
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308-0558
Practice Address - Country:US
Practice Address - Phone:952-457-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor