Provider Demographics
NPI:1720275654
Name:MINOCCHI, DANIEL C (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:MINOCCHI
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 1:2167 WEHRLE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7038
Mailing Address - Country:US
Mailing Address - Phone:716-534-9044
Mailing Address - Fax:716-580-3948
Practice Address - Street 1:2167 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7038
Practice Address - Country:US
Practice Address - Phone:716-534-9044
Practice Address - Fax:716-580-3948
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3910111NS0005X
NY011563111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician