Healthcare Provider Details

I. General information

NPI: 1093993883
Provider Name (Legal Business Name): DANIEL FRANCIS MASSA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N LOUISVILLE ST STE C
HARLEM GA
30814-5356
US

IV. Provider business mailing address

315 N LOUISVILLE ST STE C
HARLEM GA
30814-5356
US

V. Phone/Fax

Practice location:
  • Phone: 706-901-5060
  • Fax:
Mailing address:
  • Phone: 478-299-0496
  • Fax: 814-375-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009835
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008219
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: