Basic Information
| Provider Information | |||||||||
| NPI: | 1093145583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACHALA | ||||||||
| FirstName: | DAYNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | BCABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 407 THOMAS LN | ||||||||
| Address2: | |||||||||
| City: | GRAND BLANC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484391575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109235372 | ||||||||
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| Practice Location | |||||||||
| Address1: | 138 W HIGHLAND RD | ||||||||
| Address2: | 400-600 | ||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488432168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173764831 | ||||||||
| FaxNumber: | 5173764833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2013 | ||||||||
| LastUpdateDate: | 08/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 106E00000X | 0-16-7445 | MI | Y |
No ID Information.