Provider Demographics
NPI:1467997585
Name:CAVANAUGH, DANIEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:CAVANAUGH
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 1:301 BRADY AVE
Mailing Address - Street 2:
Mailing Address - City:LANSE
Mailing Address - State:MI
Mailing Address - Zip Code:49946-1434
Mailing Address - Country:US
Mailing Address - Phone:906-201-0340
Mailing Address - Fax:
Practice Address - Street 1:12 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LANSE
Practice Address - State:MI
Practice Address - Zip Code:49946-1040
Practice Address - Country:US
Practice Address - Phone:906-524-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor