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Individual

WILLIAM DANIELS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.S., EPC

Contact information

Practice address
600 N. JORDAN AVE., BLOOMINGTON, IN 47405
(812) 855-7338
Mailing address
PO BOX 335, STINESVILLE, IN 47464
(317) 626-2401

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35 6001673
IU HEALTH CENTER
IN
Enumeration date
08/31/2016
Last updated
08/31/2016
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