Provider Demographics
NPI:1679736961
Name:REYES, DANIEL ANTHONY (DC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ANTHONY
Last Name:REYES
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 1:2333 W WHITENDALE AVE
Mailing Address - Street 2:#D
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8701
Mailing Address - Country:US
Mailing Address - Phone:559-627-6055
Mailing Address - Fax:559-627-6066
Practice Address - Street 1:2333 W WHITENDALE
Practice Address - Street 2:#D
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-627-6055
Practice Address - Fax:559-627-6066
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor