Provider Demographics
NPI:1508064320
Name:STANBERRY, DANIEL LESLIE (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LESLIE
Last Name:STANBERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:STANBERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC LLC
Mailing Address - Street 1:319T ASPEN BUSINESS CENTER
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611
Mailing Address - Country:US
Mailing Address - Phone:970-925-8980
Mailing Address - Fax:970-920-4799
Practice Address - Street 1:319T ASPEN BUSINESS CENTER
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611
Practice Address - Country:US
Practice Address - Phone:970-925-8980
Practice Address - Fax:970-920-4799
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor