Provider Demographics
NPI:1134298110
Name:MCDANIEL, CHRIS M (DC, CCEP)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:M
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:DC, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20701 N SCOTTSDALE RD
Mailing Address - Street 2:STE 107-468
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6413
Mailing Address - Country:US
Mailing Address - Phone:480-342-9191
Mailing Address - Fax:480-342-9324
Practice Address - Street 1:8700 E PINNACLE PEAK RD
Practice Address - Street 2:STE 109
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3541
Practice Address - Country:US
Practice Address - Phone:480-342-9191
Practice Address - Fax:480-342-9324
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7272111N00000X
ID581111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ11198878OtherCAQH ID NUMBER
AZ663772OtherACN/UNITED HEALTHCARE
AZ0941080OtherBCBS
AZ11198878OtherCAQH ID NUMBER
AZU93430Medicare UPIN