Provider Demographics
NPI:1598067589
Name:HUNGERFORD, DANIEL WILLAIM (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLAIM
Last Name:HUNGERFORD
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 1:4172 LAKE MICHIGAN DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-4527
Mailing Address - Country:US
Mailing Address - Phone:269-792-9952
Mailing Address - Fax:269-792-6459
Practice Address - Street 1:135 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1137
Practice Address - Country:US
Practice Address - Phone:269-792-9952
Practice Address - Fax:269-792-6459
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor