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Individual

DANIEL GERARD CALLAHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
5605 WASHINGTON AVE STE 9, MT PLEASANT, WI 53406-4056
(262) 554-4522
Mailing address
1328 95TH AVE, KENOSHA, WI 53144-7718
(262) 859-2052

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
55-377
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55-377
WISCONSIN LICENSE NUMBER
WI
Enumeration date
03/01/2019
Last updated
03/01/2019
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