Provider Demographics
NPI:1770641094
Name:HILSMAN, DANIEL RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAY
Last Name:HILSMAN
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 1:5951 PRESERVATION DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MI
Mailing Address - Zip Code:49419-9693
Mailing Address - Country:US
Mailing Address - Phone:616-422-5159
Mailing Address - Fax:616-422-5159
Practice Address - Street 1:400 136TH AVE
Practice Address - Street 2:STE 413
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2923
Practice Address - Country:US
Practice Address - Phone:616-355-5444
Practice Address - Fax:616-355-5444
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95-0G0-11490OtherBLUE CROSS BLUE SHIELD
P28720001Medicare ID - Type Unspecified