Healthcare Provider Details

I. General information

NPI: 1821382201
Provider Name (Legal Business Name): DANIEL DUWAYNE HAMILTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 03/10/2024
Certification Date: 03/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 FASHION RIDGE RD
DRY RIDGE KY
41035-9609
US

IV. Provider business mailing address

5900 CENTENNIAL CIR STE 180
FLORENCE KY
41042-4249
US

V. Phone/Fax

Practice location:
  • Phone: 859-643-6100
  • Fax: 859-643-6105
Mailing address:
  • Phone: 859-620-1325
  • Fax: 859-282-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number270502
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: