Healthcare Provider Details

I. General information

NPI: 1023195492
Provider Name (Legal Business Name): DANIEL W CAMPBELL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 STATE ST
HARBOR BEACH MI
48441-1203
US

IV. Provider business mailing address

154 STATE ST
HARBOR BEACH MI
48441-1203
US

V. Phone/Fax

Practice location:
  • Phone: 989-479-6778
  • Fax:
Mailing address:
  • Phone: 989-479-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301004955
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: