Provider Demographics
NPI:1437378551
Name:MCDANIEL, CHRIS (DC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:MCDANIEL
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 1:1345 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3909
Mailing Address - Country:US
Mailing Address - Phone:805-781-8333
Mailing Address - Fax:805-541-6444
Practice Address - Street 1:1345 BROAD ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3909
Practice Address - Country:US
Practice Address - Phone:805-781-8333
Practice Address - Fax:805-541-6444
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25985111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology