=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578504122
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIAN PERRY DANIELS D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2006
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33 BEDFORD ST STE 10
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02420-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-676-0008
-----------------------------------------------------
Fax | 781-676-0014
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33 BEDFORD ST STE 10
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02420-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-676-0008
-----------------------------------------------------
Fax | 781-676-0014
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH2268
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------