MEDICARE: DANIEL MCGAUGH

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	2021004671	MO

General Provider Information

NPI Number	:	1679165880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL MCGAUGH

Provider Business Mailing Address
First Line	:	4200 MERCHANT ST STE 105
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5816
Country	:	US
Telephone Number	:
Fax Number	:	573-777-5900

Provider Business Practice Location Address
First Line	:	10 W NIFONG BLVD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-6011
Country	:	US
Telephone Number	:	573-442-5268
Fax Number	:

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

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	02/09/2021

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Directions to “ DANIEL MCGAUGH ” Practice Location

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