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General NPI Number Information
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NPI Number | 1700106499
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Entity Type | Individual
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Provider Name | DANIEL O'DONNELL JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 1907 NEW RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1545
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Country | US
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Telephone | 609-569-1040
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Fax | 609-241-0041
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Provider Business Mailing Address
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Address Line | 514 N CORNWALL AVE
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City | VENTNOR CITY
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State | NJ
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Zip | 08406-1356
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Country | US
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Telephone |
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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 | 38MC00693400
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License Number State | NJ
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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 | DC010433
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License Number State | PA
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