Provider Demographics
NPI:1497095996
Name:DANAE HAUTAMAKI PLLC
Entity Type:Organization
Organization Name:DANAE HAUTAMAKI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANAE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUTAMAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-817-3086
Mailing Address - Street 1:105 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2133
Mailing Address - Country:US
Mailing Address - Phone:715-817-3086
Mailing Address - Fax:
Practice Address - Street 1:105 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2133
Practice Address - Country:US
Practice Address - Phone:715-817-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5734261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center