Individual
MARY L DANNIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BASHAS PLAZA HIGHWAY 191, CHINLE, AZ 86503-2374
(928) 755-2278
Mailing address
PO BOX 2374, CHINLE, AZ 86503-2374
(928) 755-2278
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
525123
—
AZ
Enumeration date
06/05/2009
Last updated
06/05/2009
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