Individual
MR. DANIEL ROGERS DAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
3916 N. INTERTECH COURT, SUITE B, APPLETON, WI 54913
(920) 733-7726
Mailing address
1010 S ONEIDA ST, APPLETON, WI 54915-7802
(920) 733-7726
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6442-024
WI
2255A2300X
Athletic Trainer
361-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36105000
—
WI
Enumeration date
08/09/2007
Last updated
10/03/2007
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