Individual
DANIEL BANKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
717 S STATE ST, SUITE 900, FAIRMONT, MN 56031-4469
(507) 238-4949
(507) 238-3377
Mailing address
717 S STATE ST, SUITE 900, FAIRMONT, MN 56031-4469
(507) 238-4949
(507) 238-3377
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
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