Provider Demographics
NPI:1538369244
Name:KNUTSON, BRYON EUGENE (DC)
Entity type:Individual
Prefix:DR
First Name:BRYON
Middle Name:EUGENE
Last Name:KNUTSON
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 1:1681 3RD AVE W # 60
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-3025
Mailing Address - Country:US
Mailing Address - Phone:701-264-7351
Mailing Address - Fax:701-264-7352
Practice Address - Street 1:1681 3RD AVE W # 60
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-3025
Practice Address - Country:US
Practice Address - Phone:701-264-7351
Practice Address - Fax:701-264-7352
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor