Provider Demographics
NPI:1962686550
Name:EVERS, DENISE ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANNE
Last Name:EVERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:MN
Mailing Address - Zip Code:56175-1213
Mailing Address - Country:US
Mailing Address - Phone:507-629-3630
Mailing Address - Fax:507-212-6792
Practice Address - Street 1:271 3RD ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:MN
Practice Address - Zip Code:56175-1213
Practice Address - Country:US
Practice Address - Phone:507-629-3630
Practice Address - Fax:507-212-6792
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU69267Medicare UPIN