Provider Demographics
NPI:1952829400
Name:QUISBERG, JUSTIN (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:QUISBERG
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 1:4130 S NEW BRAUNFELS AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-1719
Mailing Address - Country:US
Mailing Address - Phone:210-563-7246
Mailing Address - Fax:210-549-1093
Practice Address - Street 1:4130 S NEW BRAUNFELS AVE STE 113
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1719
Practice Address - Country:US
Practice Address - Phone:702-480-9875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13643111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor