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General NPI Number Information
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NPI Number | 1477942084
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Entity Type | Individual
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Provider Name | ANGELA DAHL M.P.A., A.T.C.
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Gender | Female
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 1421 27TH ST
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City | DES MOINES
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State | IA
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Zip | 50311-3020
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Country | US
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Telephone | 515-271-4983
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Fax | 515-271-2662
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Provider Business Mailing Address
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Address Line | 2703 DOSH RD
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City | DES MOINES
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State | IA
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Zip | 50310-5904
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Country | US
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Telephone | 515-208-8292
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Fax | 515-271-2662
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 00490
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License Number State | IA
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