Individual
MR. DANIEL WAYNE INGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 779-1282
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 779-1282
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-CRM-978
OR
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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