Individual
DANIEL BANKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4879
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096N3BA
BLUE CROSS BLUE SHIELD
MN
01
—
18725
AVERA
—
05
—
490047000
—
MN
01
—
62619
SANFORD HEALTH
—
01
—
974311051596
PREFERREDONE
—
Enumeration date
09/05/2007
Last updated
05/30/2008
Update your record
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