Individual
DANIEL PHILIP DEHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20762 JUNCO CT., LAKEVILLE, MN 55044-7052
(612) 875-0445
Mailing address
20762 JUNCO CT, LAKEVILLE, MN 55044-7510
(612) 875-0445
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J020101280802
MN
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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