Individual
MYREN DEAN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
121 3RD STREET, STEPHEN, MN 56757
(218) 478-2415
(218) 478-3083
Mailing address
PO BOX 327, 121 3RD STREET, STEPHEN, MN 56757
(218) 478-2415
(218) 478-3083
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1164
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
791350940
RAILROAD MEDICARE
—
05
—
MA905525800
—
MN
01
—
MN86627AN
BCBS
MN
01
—
ND4385
BCBS
ND
Enumeration date
08/30/2006
Last updated
12/08/2022
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