Individual
SUSAN M EISENMENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
424 W 5TH ST, RED WING, MN 55066-2524
(651) 388-0097
Mailing address
424 W 5TH ST, RED WING, MN 55066-2524
(651) 388-0097
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3040
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43G75EI
BLUE CROSS BLUE SHIELD
MN
05
—
6343139-00
—
MN
Enumeration date
07/28/2006
Last updated
07/08/2007
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