Most Relevant Information
Provider Data
NPI Number: | 1003429507 |
Provider Name: | DANA DIESI CRAFT |
Entity Type: | Individual |
Taxonomy Code: | 363A00000X |
Specialty: | Physician Assistant |
License Number: |
Most Important Dates
Enumeration Date: | 08/25/2020 |
Last Updated: | 08/25/2020 |
Provider Practice Location
701 19TH ST S # 112
BIRMINGHAM
AL
352331926
Practice Location Phone/Fax
Phone: | 3373169823 |
Fax: |
Provider Mailing Location
205 WOOD DUCK DR
LAFAYETTE
LA
705074935
Provider Mailing Phone/Fax
Phone: | |
Fax: |