Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 6395 | MN |
NPI | 1528653342 |
---|---|
Provider Name | Toni Iris Buesgens |
First Address | Becker, MN 55308-9528 |
Second Address | Becker, MN 55308-9528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2021 |
Last Update Date | 03/03/2021 |