Provider Demographics
NPI:1023269776
Name:DANDA, PATRICIA ANN (MAC DM HRC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:DANDA
Suffix:
Gender:F
Credentials:MAC DM HRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 EAST UNAKA AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4085
Mailing Address - Country:US
Mailing Address - Phone:423-928-9394
Mailing Address - Fax:423-928-9394
Practice Address - Street 1:113 EAST UNAKA AVENUE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4085
Practice Address - Country:US
Practice Address - Phone:423-928-9394
Practice Address - Fax:423-928-9394
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN#17171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist