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Individual

DEAN EDWARDS REDINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1001 20TH AVE SW, MINOT, ND 58701
(701) 852-0158
(701) 852-5630
Mailing address
1001 20TH AVE SW, MINOT, ND 58701
(701) 852-0158
(701) 852-5630

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1003
SD
111N00000X
Chiropractor
Primary
367
ND
111N00000X
Chiropractor
4475
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10468
ND
01
10810
CLINIC MEDICAID
01
22705
BCBS
01
711180
GROUP PROVIDER #
Enumeration date
07/12/2006
Last updated
07/08/2007
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