Individual
MR. DANIEL JAMES DESURRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
980 2ND ST SE, BANDON, OR 97411-9475
(541) 347-9100
(541) 329-0260
Mailing address
980 2ND ST SE, BANDON, OR 97411-9475
(541) 347-9100
(541) 329-0260
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00826
OR
Other
Enumeration date
01/13/2007
Last updated
09/13/2016
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