Provider Demographics
NPI:1134180730
Name:DAHL, ANN MARIE BETH (DC)
Entity type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:BETH
Last Name:DAHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:DAHL FAMILY CHIROPRACTIC, SC INC
Mailing Address - Street 2:6626 MINERAL POINT RD
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4238
Mailing Address - Country:US
Mailing Address - Phone:608-829-0074
Mailing Address - Fax:608-829-0330
Practice Address - Street 1:6626 MINERAL POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4238
Practice Address - Country:US
Practice Address - Phone:608-829-0074
Practice Address - Fax:608-829-0330
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1134180730Medicare UPIN