Provider Demographics
NPI:1720371198
Name:DANIELS, GALEN R (PA)
Entity Type:Individual
Prefix:
First Name:GALEN
Middle Name:R
Last Name:DANIELS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-0365
Mailing Address - Country:US
Mailing Address - Phone:641-872-2063
Mailing Address - Fax:641-872-2070
Practice Address - Street 1:417 S EAST ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1860
Practice Address - Country:US
Practice Address - Phone:641-872-2063
Practice Address - Fax:641-872-2070
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2019-01-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant