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Individual

TRENT H. IVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1912 LEXINGTON AVE, SUITE 250, ROSEVILLE, MN 55113
(651) 646-2050
(651) 646-2279
Mailing address
1912 LEXINGTON AVE N STE 250, ROSEVILLE, MN 55113-6100
(651) 646-2050
(651) 646-2279

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3815
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
76D39IV
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/02/2007
Last updated
05/05/2026
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