Provider Demographics
NPI:1659032225
Name:ESCHENBACHER, ALYSIA SUE (DC)
Entity type:Individual
Prefix:DR
First Name:ALYSIA
Middle Name:SUE
Last Name:ESCHENBACHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ALYSIA
Other - Middle Name:SUE
Other - Last Name:PRZYBILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:48 29TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4589
Mailing Address - Country:US
Mailing Address - Phone:320-240-0300
Mailing Address - Fax:
Practice Address - Street 1:15774 EDGEWOOD DR.
Practice Address - Street 2:SUITE 102
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-5642
Practice Address - Country:US
Practice Address - Phone:218-829-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor