Provider Demographics
NPI:1821492398
Name:DR. EVA DAHL DC, INC
Entity Type:Organization
Organization Name:DR. EVA DAHL DC, INC
Other - Org Name:CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-331-8851
Mailing Address - Street 1:475 GATE 5 RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94965-2879
Mailing Address - Country:US
Mailing Address - Phone:415-331-8851
Mailing Address - Fax:
Practice Address - Street 1:475 GATE 5 RD STE 120
Practice Address - Street 2:
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-2879
Practice Address - Country:US
Practice Address - Phone:415-331-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty