Individual
COLEEN E DAHL
Active
Individual
COLEEN E DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007843L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026301850001
—
PA
01
—
12091886
CAQH
—
Enumeration date
04/14/2010
Last updated
05/08/2014
Update your record
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