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General NPI Number Information
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NPI Number | 1407312614
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Entity Type | Individual
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Provider Name | DAVID ALLEN DANIELSON
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 615 W 5TH ST
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City | ZUMBROTA
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State | MN
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Zip | 55992-1157
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Country | US
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Telephone | 507-884-1481
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Fax | 507-732-7370
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Provider Business Mailing Address
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Address Line | 615 W 5TH ST
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City | ZUMBROTA
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State | MN
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Zip | 55992-1157
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Country | US
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Telephone | 507-884-1481
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Fax | 507-732-7370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 383010
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 383010
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License Number State | MN
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