Provider Demographics
NPI:1932272507
Name:HYATT, DANIEL EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:HYATT
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 1:7003 S HOWELL AVE STE 1300
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1402
Mailing Address - Country:US
Mailing Address - Phone:414-687-0908
Mailing Address - Fax:414-856-1901
Practice Address - Street 1:7003 S HOWELL AVE STE 1300
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-1402
Practice Address - Country:US
Practice Address - Phone:414-856-1900
Practice Address - Fax:414-762-8765
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2545-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38860400Medicaid
WI38860400Medicaid
WIU24840Medicare UPIN