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General NPI Number Information
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NPI Number | 1184732430
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Entity Type | Individual
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Provider Name | SALVATORE COSIMO DANIELE B.S., D,C.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 1905 SKIBO RD STE 103
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-0261
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Country | US
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Telephone | 910-480-1111
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Fax | 910-480-1113
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Provider Business Mailing Address
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Address Line | 439 WESTWOOD SHOPPING CTR SUITE 5
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1532
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Country | US
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Telephone | 910-480-1111
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Fax | 910-480-1113
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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 | 3330
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License Number State | NC
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