Provider Demographics
NPI:1154833127
Name:ERLANDSON, DEAN SIMON (DC)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:SIMON
Last Name:ERLANDSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2008
Mailing Address - Country:US
Mailing Address - Phone:218-998-1099
Mailing Address - Fax:218-996-4010
Practice Address - Street 1:402 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2008
Practice Address - Country:US
Practice Address - Phone:218-998-1099
Practice Address - Fax:218-998-4010
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor