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Organization
PEQUOT LAKES CHIROPRACTIC AND SPORTS INJURY CENTER P.A
Active
Organization
PEQUOT LAKES CHIROPRACTIC AND SPORTS INJURY CENTER P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN D BUELL D.C. (OWNER-DC)
(218) 568-7767
Entity
Organization
Contact information
Practice address
31095 BERGQUIST DRIVE, PEQUOT LAKES, MN 56472-0008
(218) 568-7767
(218) 568-4580
Mailing address
PO BOX 8, PEQUOT LAKES, MN 56472
(218) 568-7767
(218) 568-4580
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3271
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043813800
—
MN
Enumeration date
12/06/2006
Last updated
10/11/2012
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