Individual
DANIELLE DAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT, LMT
Contact information
Practice address
104 S PACIFIC HWY # 99, COTTAGE GROVE, OR 97424-2100
(541) 767-1616
Mailing address
4138 S E ST, SPRINGFIELD, OR 97478-7595
(541) 729-5277
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10220
OR
Other
Enumeration date
05/08/2013
Last updated
04/22/2014
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