Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2004014221 | MO |
N | 111NR0200X | Radiology | 2004014221 | MO |
N | 213ER0200X | Radiology | 2004014221 | MO |
NPI | 1275650129 |
---|---|
Provider Name | Dr. Daniel Wilson Haun |
First Address | Ballwin, MO 63011-3848 |
Second Address | Chesterfield, MO 63017-5529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2007 |
Last Update Date | 08/07/2007 |