Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | AT003459 | OH |
NPI | 1124649223 |
---|---|
Provider Name | Daniel Allen Givens |
First Address | Gahanna, OH 43230-9894 |
Second Address | Gahanna, OH 43230-9894 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2020 |
Last Update Date | 29/04/2020 |