Provider Demographics
NPI:1093993883
Name:MASSA, DANIEL FRANCIS (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:FRANCIS
Last Name:MASSA
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 1:315 N LOUISVILLE ST STE C
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-5356
Mailing Address - Country:US
Mailing Address - Phone:478-299-0496
Mailing Address - Fax:814-375-9880
Practice Address - Street 1:315 N LOUISVILLE ST STE C
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:GA
Practice Address - Zip Code:30814-5356
Practice Address - Country:US
Practice Address - Phone:706-901-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009835111N00000X
GACHIR008219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor