Individual
DANIELLE DAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
829 FLORENCE ST, KEWANEE, IL 61443-1615
(309) 312-1101
Mailing address
829 FLORENCE ST, KEWANEE, IL 61443-1615
(309) 312-1101
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D40016468681
IL
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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