Individual
JEFFREY WAYNE DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
13955 W PRESERVE BLVD # 200, BURNSVILLE, MN 55337-7733
(952) 890-0804
(952) 890-1095
Mailing address
13955 W PRESERVE BLVD # 200, BURNSVILLE, MN 55337-7733
(952) 890-0804
(952) 890-1095
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3374
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2613298-00
—
MN
01
—
45B78DA
BCBS ID NUMBER
MN
Enumeration date
08/03/2006
Last updated
02/02/2012
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