Individual
JACOB DAVID DAIGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
Mailing address
25102 THORNRIDGE DR, GRAND BLANC, MI 48439-9277
(715) 573-8692
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1107533-30
WI
Other
Enumeration date
05/14/2021
Last updated
09/30/2024
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