Provider Demographics
NPI:1982891511
Name:MCCLEERY, DANIEL MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:MCCLEERY
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 1:404 NE GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4608
Mailing Address - Country:US
Mailing Address - Phone:541-389-7103
Mailing Address - Fax:541-389-1173
Practice Address - Street 1:404 NE GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4608
Practice Address - Country:US
Practice Address - Phone:541-389-7103
Practice Address - Fax:541-389-1173
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-1294111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT67893Medicare UPIN