Individual
MATTHEW ALLEN DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11850 BLACKFOOT ST NW STE 405, COON RAPIDS, MN 55433-2773
(763) 236-0888
Mailing address
800 N 3RD ST APT 225, MINNEAPOLIS, MN 55401-2675
(608) 234-0793
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
60716
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2012
Last updated
04/24/2019
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