Individual
MR. DALLEN MCKINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2276 FRANKLIN TPKE STE 106, DANVILLE, VA 24540-5284
(434) 548-8752
(434) 836-8713
Mailing address
2276 FRANKLIN TPKE STE 106, DANVILLE, VA 24540-5284
(434) 548-8752
(434) 836-8713
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
HCO-15408
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCO-15408
VIRGINIA STATE HEALTH DEPARTMENT
VA
Enumeration date
05/18/2015
Last updated
05/18/2015
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