Individual
DR. DANIELLE VAHLKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD., D.C.
Contact information
Practice address
225 N POPLAR ST, CENTRALIA, IL 62801-3234
(618) 532-4158
Mailing address
2324 S 3RD ST, FAYETTEVILLE, IL 62258-5052
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.011845
IL
111NS0005X
Sports Physician Chiropractor
038.011845
IL
183500000X
Pharmacist
Primary
051302298
IL
183500000X
Pharmacist
2019035654
MO
Other
Enumeration date
01/01/2011
Last updated
12/16/2020
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