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General NPI Number Information
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NPI Number | 1447174990
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Entity Type | Individual
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Provider Name | EVAN HENKE DPT
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Gender | Male
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 1251 1ST ST S
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City | DICKINSON
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State | ND
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Zip | 58601-4663
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Country | US
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Telephone | 303-917-5496
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Fax | 701-390-1366
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Provider Business Mailing Address
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Address Line | 5097 99TH AVE SW
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City | LEFOR
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State | ND
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Zip | 58641-9211
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Country | US
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Telephone | 303-917-5496
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Fax | 701-390-1366
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 2945
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2945
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License Number State | ND
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