Individual
NATHAN E. DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
670 HUMBOLDT DRIVE, BIG LAKE, MN 55309
(763) 263-8433
(763) 263-2963
Mailing address
PO 88, BIG LAKE, MN 55309
(763) 263-8433
(763) 263-2963
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3099
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53159888
WAUSAU
MN
01
—
59B57N0
BLUE CROSS
MN
Enumeration date
12/29/2006
Last updated
07/08/2007
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