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Individual

DANIEL D PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
326 SAINT CROIX TRAIL SOUTH, LAKELAND, MN 55043-0294
(651) 436-7724
(651) 436-7724
Mailing address
PO BOX 294, LAKELAND, MN 55043-0294
(651) 436-7724
(651) 436-7724

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2473
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4C786LA
BCBSM
MN
Enumeration date
03/27/2008
Last updated
03/27/2008
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