Individual
DR. DANIEL HOLM EVANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
14750 CEDAR AVE, SUITE 104, APPLE VALLEY, MN 55124-4506
(952) 431-3133
Mailing address
7275 147TH ST W, STE 104, APPLE VALLEY, MN 55124-7809
(952) 431-3133
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C4302
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349C7HA
BLUE CROSS CLINIC ID
MN
01
—
349C8EV
BLUE CROSS IND. ID
MN
Enumeration date
07/21/2006
Last updated
04/10/2019
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