Daniel Bankson, P.T.

Individual provider Active NPI Physical Therapist · Fairmont, MN

NPI 1851585533 · NPPES record last updated May 30, 2008

Key facts

NPI
1851585533
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
4879 (MN)
Practice address
717 S State St
Suite 900
Fairmont, MN 56031-4469
Phone
(507) 238-4949
Fax
(507) 238-3377
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4879MNMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4879 MN Yes

Addresses

Primary practice location

717 S State St
Suite 900
Fairmont, MN 56031-4469

Mailing address

717 S State St
Suite 900
Fairmont, MN 56031-4469
Phone (507) 238-4949

Other identifiers

IdentifierTypeStateIssuer
62619OtherSANFORD HEALTH
096N3BAOtherMNBLUE CROSS BLUE SHIELD
18725OtherAVERA
974311051596OtherPREFERREDONE
490047000MedicaidMN

Other providers in Fairmont, MN

All providers in Fairmont, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.