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General NPI Number Information
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NPI Number | 1669473997
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Entity Type | Individual
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Provider Name | DANIEL JOSEPH FANSELOW D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 6 COLONIAL DR SUITE 1
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City | WESTBORO
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State | MA
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Zip | 01581-1407
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Country | US
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Telephone | 508-366-3333
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Fax | 508-366-3860
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Provider Business Mailing Address
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Address Line | 6 COLONIAL DR SUITE 1
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City | WESTBORO
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State | MA
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Zip | 01581-1407
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Country | US
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Telephone | 508-366-3333
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Fax | 508-366-3860
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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 | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 1420
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 000803
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | X005816
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License Number State | NY
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