Provider Demographics
NPI:1144974502
Name:VEENSTRA, DANIELLE AIMEE CAROLYN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:AIMEE CAROLYN
Last Name:VEENSTRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:AIMEE CAROLYN
Other - Last Name:VEENSTRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8028 22ND CT N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9307
Mailing Address - Country:US
Mailing Address - Phone:651-675-9828
Mailing Address - Fax:
Practice Address - Street 1:17595 KENWOOD TRL STE 120
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-7319
Practice Address - Country:US
Practice Address - Phone:651-675-9828
Practice Address - Fax:651-401-6468
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor