Provider Demographics
NPI:1043343627
Name:KNOWLES, DANIEL MARSHALL III (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARSHALL
Last Name:KNOWLES
Suffix:III
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 1:1715 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6347
Mailing Address - Country:US
Mailing Address - Phone:303-998-1000
Mailing Address - Fax:303-998-1003
Practice Address - Street 1:1715 15TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6347
Practice Address - Country:US
Practice Address - Phone:303-998-1000
Practice Address - Fax:303-998-1003
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO481408Medicare PIN