Provider Demographics
NPI:1992006035
Name:JUSTICE, DANIEL B (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:JUSTICE
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 1:7106 W HOOD PLACE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-222-1132
Mailing Address - Fax:509-222-1133
Practice Address - Street 1:7106 W HOOD PLACE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-222-1132
Practice Address - Fax:509-222-1133
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4122111N00000X
WACH60314301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor