Individual
DANIEL RACALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2545 ORCHARD CIRCLE DR APT 4, TRAVERSE CITY, MI 49686-1589
(989) 858-2410
Mailing address
2545 ORCHARD CIRCLE DR APT 4, TRAVERSE CITY, MI 49686-1589
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011277
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/24/2022
Last updated
09/28/2022
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