Provider Demographics
NPI:1881873370
Name:BUESCHER, BECKI (DC)
Entity type:Individual
Prefix:
First Name:BECKI
Middle Name:
Last Name:BUESCHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 38TH AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6407
Mailing Address - Country:US
Mailing Address - Phone:309-764-4004
Mailing Address - Fax:309-764-4804
Practice Address - Street 1:3440 38TH AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6407
Practice Address - Country:US
Practice Address - Phone:309-764-4004
Practice Address - Fax:309-764-4804
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor