Provider Demographics
NPI:1700084878
Name:BUMGARNER, DANIEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:BUMGARNER
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 1:1851 HILLPOINTE RD APT 212
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0976
Mailing Address - Country:US
Mailing Address - Phone:702-767-0120
Mailing Address - Fax:702-545-0063
Practice Address - Street 1:60 S STEPHANIE ST STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-5555
Practice Address - Country:US
Practice Address - Phone:702-767-0120
Practice Address - Fax:702-545-0063
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVBO2000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor