Healthcare Provider Details

I. General information

NPI: 1114851870
Provider Name (Legal Business Name): DANIEL DANIELS JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N STATE ST STE B
CARO MI
48723-1543
US

IV. Provider business mailing address

2875 E DUTCHER RD
CARO MI
48723-9351
US

V. Phone/Fax

Practice location:
  • Phone: 989-208-3847
  • Fax:
Mailing address:
  • Phone: 989-890-2388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401733
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: