Provider Demographics
NPI:1063699171
Name:DANIELS, TERRY L (DC CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:DANIELS
Suffix:
Gender:M
Credentials:DC CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-1029
Mailing Address - Country:US
Mailing Address - Phone:585-786-5830
Mailing Address - Fax:585-786-2465
Practice Address - Street 1:433 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1029
Practice Address - Country:US
Practice Address - Phone:585-786-5830
Practice Address - Fax:585-786-2465
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY665515Medicare UPIN