Basic Information
| Provider Information | |||||||||
| NPI: | 1003148842 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PFISTERER | ||||||||
| FirstName: | CRYSTAL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8942 XERXES CIR S | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554311961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524842176 | ||||||||
| FaxNumber: | 9522231134 | ||||||||
| Practice Location | |||||||||
| Address1: | 5509 EDEN PRAIRIE RD | ||||||||
| Address2: | |||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553455839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524467177 | ||||||||
| FaxNumber: | 9528435650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2010 | ||||||||
| LastUpdateDate: | 10/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 5466 | KY | N | Chiropractic Providers | Chiropractor | 111NI0013X | 877 | MN | N | Chiropractic Providers | Chiropractor | Independent Medical Examiner | 111N00000X | 5264 | MN | Y | Chiropractic Providers | Chiropractor |
No ID Information.