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Individual

NANCY DAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
66105 HUNTER RD, LA GRANDE, OR 97850-5144
(541) 963-7812
Mailing address
66105 HUNTER RD, LA GRANDE, OR 97850-5144
(541) 963-7812

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
14665
OR

Other

Enumeration date
04/01/2008
Last updated
04/01/2008
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