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NPI Code Detail

MEDICARE: DR. DANIEL A MCCOLLUM D.C.

MEDICARE: DR. DANIEL A MCCOLLUM D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorSC1792SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11053398503OTHERSCNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31792OTHERSCSTATE LICENSE

General Provider Information

NPI Number : 1053398503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL A MCCOLLUM D.C.
Provider Business Mailing Address
First Line : 115 BRUSHY CREEK RD
Second Line :
City : EASLEY
State : SC
Zip : 29642-1120
Country : US
Telephone Number : 864-855-1655
Fax Number : 864-855-1323
Provider Business Practice Location Address
First Line : 115 BRUSHY CREEK RD
Second Line :
City : EASLEY
State : SC
Zip : 29642-1120
Country : US
Telephone Number : 864-855-1655
Fax Number : 864-855-1323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 10/04/2011

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