Provider Demographics
NPI:1629150842
Name:MCDANIEL, JULIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 EXCHANGE ST
Mailing Address - Street 2:STE 105
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-4425
Mailing Address - Country:US
Mailing Address - Phone:802-388-0970
Mailing Address - Fax:802-388-0917
Practice Address - Street 1:1330 EXCHANGE ST
Practice Address - Street 2:STE 105
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-4425
Practice Address - Country:US
Practice Address - Phone:802-388-0970
Practice Address - Fax:802-388-0917
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTU06409Medicare UPIN
VTVT9934Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER