Individual
MRS. DANIELLE MARIE ANDERSON HERTAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11041 WISCONSIN AVE N, CHAMPLIN, MN 55316-3721
(763) 482-2477
(763) 424-4684
Mailing address
11041 WISCONSIN AVE N, CHAMPLIN, MN 55316-3721
(763) 482-2477
(763) 424-4684
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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