Provider Demographics
NPI:1124172887
Name:DUONG, DANIELLE B (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:B
Last Name:DUONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1944
Mailing Address - Country:US
Mailing Address - Phone:440-466-1860
Mailing Address - Fax:440-466-0710
Practice Address - Street 1:773 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1944
Practice Address - Country:US
Practice Address - Phone:440-466-1860
Practice Address - Fax:440-466-0710
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011454-1111N00000X
OH3875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor