Provider Demographics
NPI:1982368254
Name:BUSCHBACHER, AUSTIN RUSSELL (DC)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:RUSSELL
Last Name:BUSCHBACHER
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 1:13921 RIVERSIDE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5321
Mailing Address - Country:US
Mailing Address - Phone:734-674-8321
Mailing Address - Fax:
Practice Address - Street 1:37657 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1543
Practice Address - Country:US
Practice Address - Phone:734-884-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-23
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011142111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor