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General NPI Number Information
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NPI Number | 1003984618
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Entity Type | Individual
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Provider Name | STANLEY BRUCE DANIELS D C
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5015 S PENNSYLVANIA AVE
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City | LANSING
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State | MI
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Zip | 48910-7622
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Country | US
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Telephone | 517-393-5066
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Fax |
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Provider Business Mailing Address
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Address Line | 5015 S PENNSYLVANIA AVE
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City | LANSING
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State | MI
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Zip | 48910-7622
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Country | US
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Telephone | 517-393-5066
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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 | SD004350
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License Number State | MI
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