Provider Demographics
NPI:1982268470
Name:LINGL, KRISTEN (DC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:LINGL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 BROADWAY ST STE 125
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2686
Mailing Address - Country:US
Mailing Address - Phone:320-763-0313
Mailing Address - Fax:320-763-4635
Practice Address - Street 1:1804 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2718
Practice Address - Country:US
Practice Address - Phone:320-763-0313
Practice Address - Fax:320-763-4635
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor