Provider Demographics
NPI:1912976341
Name:MINOR, DANNY J (DC)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:J
Last Name:MINOR
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 1:936 PARK AVE.
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1297
Mailing Address - Country:US
Mailing Address - Phone:276-679-2321
Mailing Address - Fax:
Practice Address - Street 1:936 PARK AVE.
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1297
Practice Address - Country:US
Practice Address - Phone:276-679-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350000560Medicare ID - Type Unspecified
T21440Medicare UPIN