Healthcare Provider Details

I. General information

NPI: 1003148842
Provider Name (Legal Business Name): CRYSTAL A PFISTERER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 10/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5509 EDEN PRAIRIE RD
MINNETONKA MN
55345-5839
US

IV. Provider business mailing address

8942 XERXES CIR S
BLOOMINGTON MN
55431-1961
US

V. Phone/Fax

Practice location:
  • Phone: 952-446-7177
  • Fax: 952-843-5650
Mailing address:
  • Phone: 952-484-2176
  • Fax: 952-223-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5466
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number877
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5264
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: