Individual
CORINNE DAUKSAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1500 BIRCHMONT DR NE # 29, BEMIDJI, MN 56601-2600
(701) 866-9484
Mailing address
1500 BIRCHMONT DR NE # 29, BEMIDJI, MN 56601-2600
(701) 866-9484
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
2135
MN
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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