Provider Demographics
NPI:1982357489
Name:PRIESTLEY, DANIELLE (DC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PRIESTLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 GRANDE VALLEY AVE SW UNIT 2621
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3546
Mailing Address - Country:US
Mailing Address - Phone:507-254-3268
Mailing Address - Fax:
Practice Address - Street 1:2571 CLARE LN NE STE 104
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-8416
Practice Address - Country:US
Practice Address - Phone:507-405-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor