Provider Demographics
NPI:1376661017
Name:HARGROVE, DANNY MAX (DC)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:MAX
Last Name:HARGROVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:679 PLEASANT ST
Mailing Address - Street 2:SUITE 715
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1380
Mailing Address - Country:US
Mailing Address - Phone:508-792-2990
Mailing Address - Fax:508-792-2996
Practice Address - Street 1:679 PLEASANT ST
Practice Address - Street 2:SUITE 715
Practice Address - City:PAXTON
Practice Address - State:MA
Practice Address - Zip Code:01612-1380
Practice Address - Country:US
Practice Address - Phone:508-792-2990
Practice Address - Fax:508-792-2996
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1376661017Medicare UPIN