Provider Demographics
NPI:1871886440
Name:DAHL, EMILY JENNY (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JENNY
Last Name:DAHL
Suffix:
Gender:F
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:JENNY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2052 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1650
Mailing Address - Country:US
Mailing Address - Phone:651-255-9999
Mailing Address - Fax:651-699-2065
Practice Address - Street 1:2052 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1650
Practice Address - Country:US
Practice Address - Phone:651-698-2516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor