Provider Demographics
NPI:1538266242
Name:KRUSSEL, KRISTIN MCLAIN (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MCLAIN
Last Name:KRUSSEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:MILONAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7649 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3910
Mailing Address - Country:US
Mailing Address - Phone:314-324-2507
Mailing Address - Fax:
Practice Address - Street 1:7649 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-3910
Practice Address - Country:US
Practice Address - Phone:314-324-2507
Practice Address - Fax:314-725-0664
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006003271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor