Provider Demographics
NPI:1063280113
Name:SUH, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:SUH
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 1:3259 E SUNSHINE ST STE DD2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2143
Mailing Address - Country:US
Mailing Address - Phone:417-730-9233
Mailing Address - Fax:
Practice Address - Street 1:3259 E SUNSHINE ST STE DD2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2143
Practice Address - Country:US
Practice Address - Phone:417-730-9233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023048371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor