Provider Demographics
NPI:1033129275
Name:ESPOSITO, DANIEL CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CHARLES
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 60TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-4099
Mailing Address - Country:US
Mailing Address - Phone:262-657-7744
Mailing Address - Fax:262-657-7753
Practice Address - Street 1:1024 60TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4099
Practice Address - Country:US
Practice Address - Phone:262-657-7744
Practice Address - Fax:262-657-7753
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38887800Medicaid
WIU55949Medicare UPIN