Healthcare Provider Details

I. General information

NPI: 1336368372
Provider Name (Legal Business Name): DENIS BOERJAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 4TH ST
SAINT ANSGAR IA
50472-1316
US

IV. Provider business mailing address

417 W 4TH ST
SAINT ANSGAR IA
50472-1316
US

V. Phone/Fax

Practice location:
  • Phone: 507-273-7236
  • Fax:
Mailing address:
  • Phone: 507-273-7236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMN 1344
License Number StateMN

VIII. Authorized Official

Name: DR. DENIS JOHN BOERJAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 507-273-7236