Provider Demographics
NPI:1407221468
Name:DANIEL CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:DANIEL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JAMIE
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:434-483-8118
Mailing Address - Street 1:2276 FRANKLIN TPKE STE 115
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-5284
Mailing Address - Country:US
Mailing Address - Phone:434-483-8118
Mailing Address - Fax:434-228-7040
Practice Address - Street 1:2276 FRANKLIN TPKE STE 115
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5284
Practice Address - Country:US
Practice Address - Phone:434-483-8118
Practice Address - Fax:434-228-7040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty