Provider Demographics
NPI:1790925642
Name:SENTER, DANIEL REESE III (MT,AMMA,NCTMB)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:REESE
Last Name:SENTER
Suffix:III
Gender:M
Credentials:MT,AMMA,NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 FILLMORE DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6233
Mailing Address - Country:US
Mailing Address - Phone:662-213-8921
Mailing Address - Fax:
Practice Address - Street 1:429 N GLOSTER ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-3625
Practice Address - Country:US
Practice Address - Phone:662-213-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist