Provider Demographics
NPI:1356526578
Name:DANIEL R MCDONELL DC PC
Entity type:Organization
Organization Name:DANIEL R MCDONELL DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCDONELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-721-3280
Mailing Address - Street 1:3700 SOUTH RUSSELL
Mailing Address - Street 2:B100
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8574
Mailing Address - Country:US
Mailing Address - Phone:406-721-3280
Mailing Address - Fax:406-541-3281
Practice Address - Street 1:3700 SOUTH RUSSELL
Practice Address - Street 2:B100
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8574
Practice Address - Country:US
Practice Address - Phone:406-721-3280
Practice Address - Fax:406-541-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty