Provider Demographics
NPI:1821199506
Name:JOSEPH, DANIEL EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:JOSEPH
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 1:1000 ST HWY 13
Mailing Address - Street 2:PO BOX 49
Mailing Address - City:WISCONSIN DELLS
Mailing Address - State:WI
Mailing Address - Zip Code:53965-0049
Mailing Address - Country:US
Mailing Address - Phone:608-254-4244
Mailing Address - Fax:608-253-5714
Practice Address - Street 1:1000 ST HWY 13
Practice Address - Street 2:
Practice Address - City:WISCONSIN DELLS
Practice Address - State:WI
Practice Address - Zip Code:53965-0049
Practice Address - Country:US
Practice Address - Phone:608-254-4244
Practice Address - Fax:608-253-5714
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3556-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00154710OtherMEDICARE RAILROAD
WI000135775OtherPTAN
WI558386OtherDEAN CARE HMO
WI558386OtherDEAN CARE HMO
WI000135775OtherPTAN