Provider Demographics
NPI:1679841589
Name:MARTIN, DANIEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:MARTIN
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 1:227 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5819
Mailing Address - Country:US
Mailing Address - Phone:724-284-1111
Mailing Address - Fax:724-284-1101
Practice Address - Street 1:1654 MARDON DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-1949
Practice Address - Country:US
Practice Address - Phone:937-672-7681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC101506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA235061G3Medicare PIN