Provider Demographics
NPI:1851040661
Name:WOJTAK, DANIELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:WOJTAK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4010
Mailing Address - Country:US
Mailing Address - Phone:406-624-6039
Mailing Address - Fax:406-262-8887
Practice Address - Street 1:1528 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4010
Practice Address - Country:US
Practice Address - Phone:406-624-6039
Practice Address - Fax:406-262-8887
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61288153175F00000X
MTAHC-NAT-LIC-2817175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath