MEDICARE: DR. DANIEL EARL LOLLAR DC

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
1	111N00000X	Chiropractor	1330	OH

General Provider Information

NPI Number	:	1184664419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL EARL LOLLAR DC

Provider Business Mailing Address
First Line	:	2439 N REYNOLDS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-2840
Country	:	US
Telephone Number	:	419-537-8624
Fax Number	:	419-535-7220

Provider Business Practice Location Address
First Line	:	2439 N REYNOLDS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-2840
Country	:	US
Telephone Number	:	419-537-8624
Fax Number	:	419-535-7220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	04/07/2008

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