Provider Demographics
NPI:1568203271
Name:KUSS, SAMUEL (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:KUSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 BUNKER LAKE BLVD NW STE 105
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1053
Mailing Address - Country:US
Mailing Address - Phone:763-330-0393
Mailing Address - Fax:763-316-4189
Practice Address - Street 1:440 BUNKER LAKE BLVD NW STE 105
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-1053
Practice Address - Country:US
Practice Address - Phone:763-330-0393
Practice Address - Fax:763-316-4189
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor