Provider Demographics
NPI:1962720151
Name:MUELLER, KRYSTA LYNETTE (DC)
Entity type:Individual
Prefix:DR
First Name:KRYSTA
Middle Name:LYNETTE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRYSTA
Other - Middle Name:LYNETTE
Other - Last Name:SPUHL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:37 SAINT ANDREWS DRIVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-4946
Mailing Address - Country:US
Mailing Address - Phone:636-583-0700
Mailing Address - Fax:636-583-0799
Practice Address - Street 1:37 SAINT ANDREWS DRIVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-4946
Practice Address - Country:US
Practice Address - Phone:636-583-0700
Practice Address - Fax:636-583-0799
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010013748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor