Provider Demographics
NPI:1083697338
Name:BECKER, DANIEL JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:BECKER
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:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-0912
Mailing Address - Country:US
Mailing Address - Phone:828-817-5524
Mailing Address - Fax:866-518-5637
Practice Address - Street 1:104 PALMER ST
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3433
Practice Address - Country:US
Practice Address - Phone:828-817-5524
Practice Address - Fax:866-518-5637
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3122111N00000X
SC2539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1407906290OtherPRACTICE NPI
NC5902464Medicaid
NC5902464Medicaid