Healthcare Provider Details

I. General information

NPI: 1598693749
Provider Name (Legal Business Name): DANIEL EVERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 ADAMS RD
HOLDEN MA
01520-1801
US

IV. Provider business mailing address

38 SCHOOL ST
TROY NH
03465-2130
US

V. Phone/Fax

Practice location:
  • Phone: 774-230-0047
  • Fax:
Mailing address:
  • Phone: 774-230-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12689-MT-MT
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: