Provider Demographics
NPI:1396844056
Name:DALES, DANNY JOE (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:JOE
Last Name:DALES
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111A SAUNDERS LN
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-9278
Mailing Address - Country:US
Mailing Address - Phone:276-326-3852
Mailing Address - Fax:276-322-3308
Practice Address - Street 1:111A SAUNDERS LN
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-9278
Practice Address - Country:US
Practice Address - Phone:276-326-3852
Practice Address - Fax:276-322-3308
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA542021508OtherTAX ID
VAU66458Medicare UPIN