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General NPI Number Information
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NPI Number | 1003828047
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Entity Type | Individual
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Provider Name | DANIEL J JUDGE D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 725 S ADAMS RD SUITE 198
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6902
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Country | US
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Telephone | 248-885-3866
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 BEAUFIELD ST
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City | FERNDALE
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State | MI
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Zip | 48220-1612
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Country | US
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Telephone | 248-885-3866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034638
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301009205
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License Number State | MI
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