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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