Provider Demographics
NPI:1356363105
Name:DAY, DANIEL P (DC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:P
Last Name:DAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 E NORTH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-6542
Mailing Address - Country:US
Mailing Address - Phone:918-915-0312
Mailing Address - Fax:
Practice Address - Street 1:1558 E NORTH RIDGE DR
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-6542
Practice Address - Country:US
Practice Address - Phone:918-915-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2016970Medicaid
U52033Medicare ID - Type Unspecified
U52033Medicare UPIN