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General NPI Number Information
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NPI Number | 1396640322
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Entity Type | Organization
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Legal Business Name | EVRBRANCH LLC
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 1439 ARCADE ST STE 220
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City | SAINT PAUL
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State | MN
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Zip | 55106-1829
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Country | US
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Telephone | 651-377-1166
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Fax | 651-377-2409
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Provider Business Mailing Address
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Address Line | 6140 LAMAR AVE S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-1660
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Country | US
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Telephone | 651-377-1166
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Fax | 651-377-2409
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Authorized Official
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Title or Position | LEAD EMPLOYEE
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Name | NEUCHEE CHANG
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Credential |
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Telephone | 651-377-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | NULL
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