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Individual

DAVID ALLEN DANIELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
615 W 5TH ST, ZUMBROTA, MN 55992-1157
(507) 884-1481
(507) 732-7370
Mailing address
615 W 5TH ST, ZUMBROTA, MN 55992-1157
(507) 884-1481
(507) 732-7370

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
383010
MN
347C00000X
Private Vehicle
Primary
383010
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
383010
STS #383010
MN
Enumeration date
02/12/2019
Last updated
02/12/2019
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