Provider Demographics
NPI:1093012692
Name:ZAGST, DANIEL P (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:ZAGST
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 1:162 SARDIS RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-7961
Mailing Address - Country:US
Mailing Address - Phone:716-912-4360
Mailing Address - Fax:
Practice Address - Street 1:612 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2312
Practice Address - Country:US
Practice Address - Phone:704-664-3455
Practice Address - Fax:704-664-2827
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor