Individual
DEIRDRE LEIGH DANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10 CRATER LAKE AVE, MEDFORD, OR 97504-7445
(541) 608-0169
Mailing address
5003 GRIFFIN CREEK RD, MEDFORD, OR 97501-9586
(541) 608-0488
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
282576
OR
111N00000X
Chiropractor
782
MT
Other
Enumeration date
09/27/2007
Last updated
09/27/2007
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