Provider Demographics
NPI:1710989058
Name:MAGNUSON, DARIN J (DC)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:J
Last Name:MAGNUSON
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 1:23 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:MN
Mailing Address - Zip Code:56097-1617
Mailing Address - Country:US
Mailing Address - Phone:507-553-3175
Mailing Address - Fax:507-553-3176
Practice Address - Street 1:23 3RD ST SE
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:MN
Practice Address - Zip Code:56097-1617
Practice Address - Country:US
Practice Address - Phone:507-553-3175
Practice Address - Fax:507-553-3176
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC3692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN316L0MAOtherBC/BS GROUP ID
MN316L1MAOtherBC/BS INDIVIDUAL ID
MN316L1MAOtherBC/BS INDIVIDUAL ID