Provider Demographics
NPI:1336701036
Name:RUFUS, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:RUFUS
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 1:206 E MILLER RD
Mailing Address - Street 2:
Mailing Address - City:EDELSTEIN
Mailing Address - State:IL
Mailing Address - Zip Code:61526-9740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 CONCORD AVENUE
Practice Address - Street 2:STE 101
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3366
Practice Address - Country:US
Practice Address - Phone:302-777-5551
Practice Address - Fax:302-777-5567
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000992111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor