Provider Demographics
NPI:1265449375
Name:KAUFFMAN, DANIELLE B (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:B
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7620 E 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-9182
Mailing Address - Country:US
Mailing Address - Phone:219-662-9855
Mailing Address - Fax:219-662-1290
Practice Address - Street 1:7620 E 109TH AVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-9182
Practice Address - Country:US
Practice Address - Phone:219-662-9855
Practice Address - Fax:219-662-1290
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001232A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U02222Medicare UPIN
IN408020AMedicare PIN