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Individual

DR. THERESE B DAHL

Active
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Individual

DR. THERESE B DAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1532
WI
152W00000X
Optometrist
Primary
OPL1525
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
078593800
FL
01
114116
EYEMED
01
1213330001
DMNS CLEARING HOUSE
01
180004904
RAILROAD MEDICARE
01
27596
AVESIS
Enumeration date
11/17/2006
Last updated
02/04/2009
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