Provider Demographics
NPI:1649239583
Name:DUFFY, DANIEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:DUFFY
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 1:403 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-1902
Mailing Address - Country:US
Mailing Address - Phone:515-465-3585
Mailing Address - Fax:515-465-4651
Practice Address - Street 1:403 1ST AVE
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-1902
Practice Address - Country:US
Practice Address - Phone:515-465-3585
Practice Address - Fax:515-465-4651
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0179341Medicaid
IAU70840Medicare UPIN
IA0179341Medicaid