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NPI Code Detail

MEDICARE: DR. DANIEL THOMAS LADEAIROUS D.C.

MEDICARE: DR. DANIEL THOMAS LADEAIROUS D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC 30095CA

General Provider Information

NPI Number : 1255414017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL THOMAS LADEAIROUS D.C.
Provider Business Mailing Address
First Line : 5684 E CHRISTINE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93727-6142
Country : US
Telephone Number : 559-255-1268
Fax Number :
Provider Business Practice Location Address
First Line : 200 W SHAW AVE
Second Line : #114
City : CLOVIS
State : CA
Zip : 93612-3684
Country : US
Telephone Number : 559-273-6540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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