Provider Demographics
NPI:1295701902
Name:DANIELS, JAMES EDWARD (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:DANIELS
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 1:79 HILLSDALE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1208
Mailing Address - Country:US
Mailing Address - Phone:517-439-9800
Mailing Address - Fax:517-439-1230
Practice Address - Street 1:79 HILLSDALE ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1208
Practice Address - Country:US
Practice Address - Phone:517-439-9800
Practice Address - Fax:517-439-1230
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
950C06053OtherBCBS
C06053003Medicare ID - Type Unspecified
950C06053OtherBCBS