Provider Demographics
NPI:1326050527
Name:DANIELS, JOHN TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TODD
Last Name:DANIELS
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 1:4815 W 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1510
Mailing Address - Country:US
Mailing Address - Phone:720-427-2175
Mailing Address - Fax:720-974-6061
Practice Address - Street 1:2553 S COLORADO BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5940
Practice Address - Country:US
Practice Address - Phone:720-974-6060
Practice Address - Fax:720-974-6061
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor