Provider Demographics
NPI:1043676596
Name:HANDRICH, DANIEL (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HANDRICH
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 1:1221 E NORTHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-8415
Mailing Address - Country:US
Mailing Address - Phone:920-954-1002
Mailing Address - Fax:920-954-1006
Practice Address - Street 1:1221 E NORTHLAND AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-8415
Practice Address - Country:US
Practice Address - Phone:812-914-2185
Practice Address - Fax:920-954-1006
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5430-12111N00000X
IN08002850A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor